In 1920 the Bulgarian Red Cross association opened a Red Cross hospital near Sofia as part of the nursing school. The idea of setting up an emergency hospital belongs to dozens of Bulgarian medics who graduated and specialized in Russia, France, Austria, Germany, USA. It soon developed into a fundamental element of medical care in Sofia.

With the help of benefactors the hospital organized a wide range of social activities. During World War II it set up field hospitals. After 1945 the Red Cross hospital became the principal first aid facility in Bulgaria. In 1947 it organized the first air ambulance in the country. Since 1951 it has borne the name of Russian field surgeon Nikolay Pirogov.