The hospital underwent a major Israeli renovation and expansion.[21][22] The project was designed by Israeli architects Gershon Tzapor and Benjamin Edelson in their Tel-Aviv office, both well experienced in the construction of high standard hospitals.[21] The project was done in the 1980s as part of a project to improve the living conditions of Gaza residents.[23]

This project came as part of the Israeli idea of mutual existence between Jews and Arabs. The project intended to house 900 beds in the entire campus, a 50 dunam area. The Israeli additions were considered to be in the same standard as those hospital wings in Israeli hospitals such as Tel HaShomer.[21] The architecture of the hospital came to reflect the modernist and post modernist trends in Israeli architecture.[21] In particular was the similarity of the project to existing Israeli hospitals such as the facades of the Bezalel building in Jerusalem.[22] Similarly to other Israeli projects, the building was built with sharpened diagonal staircases, akin to projects by Israeli architects Dan Eitan, Shlomit Nadler and others at the time.[22]

The architects also designed and built a large array of underground infrastructure, which the IDF later pointed to as part of the underground Hamas command in 2014 and in the 2023 Israel-Hamas war.[21][10][8][22] In particular, in 1983, the Israelis built „a secure underground operating room and tunnel network“ beneath Building 2 of the hospital.[