When Siriraj Hospital was first established, waterways were the main means of transport; patients from the Bangkok side of the Chao Phraya River could only travel to the hospital on the Thon Buri side by boat. The first waterfront pavilion, a wooden structure with a gable roof, was erected during the reign of King Rama V.

The floating platform at the pier was used for landing of patients and visitors. In 1923, during the renovation of Siriraj Hospital, a new pavilion, designed by Luang Wisan Sinlapakam was built.

The pavilion is in the neo-classical style popular at the end of the 18th and beginning of the 19th centuries. The design achieves balance in composition and architectural proportions. The beautiful building has been well maintained over the years. In 2000 Siriraj Hospital earned an Outstanding Architectural Preservation Award (Building Class) from the Association of Siamese Architects for its care of the pavilion. Siriraj Waterfront Pavilion is now used only on special occasions, such as visits by His Majesty the King or members of the royal family, and for the Faculty of Medicine’s Freshmen Welcome ceremony.