Although originally foreseen for sick children, the Lisbon Estefânia Hospital opened in 1878, twenty years after its foundation, as an institution for adults. The complex creation of this hospital reflects an extremely rich period in Portuguese hospital history. In a country marked by a progressive secularisation of public services such as assistance, and at a time when public authorities showed increasing interest in childhood protection issues, questions of morality and hygiene encouraged a separate hospital for the youngest patients. However the city hospitals of the Portuguese capital were also in the middle of a crisis (lack of beds, obsolete structures, a mixing up of certain pathologies), which gave rise to a vigorous debate concerning the size, location and design of their facilities. Although the urgency of needs prevented the creation of an exclusively pediatric hospital, the opening of a service reserved for children at the Estefânia hospital marked the starting point of pediatric hospitalisation in Portugal.