The first hospital in Saratov, known as the Alexandrov Zemstvo Hospital (now the 2nd City Hospital), was opened in 1806. It served patients not only from the city but from the entire province, which explains its name "zemstvo". The funds for its construction were raised by Saratov nobles and merchants, as well as Emperor Alexander I. The hospital struggled to cope with the influx of patients, and up to 300 people were accommodated in its corridors, although it was designed for 200.

The construction of the city hospital was taken up by the townspeople, of whom there were about two thousand in Saratov. Starting in 1856, they began to raise funds for the construction, but bureaucratic difficulties delayed the process. Only after Emperor Alexander II declared war on Turkey in 1877 were three military hospitals organized in the city. However, due to the remoteness of the combat actions, they were not needed and were soon closed. Their property was transferred to the City Administration, which opened a temporary city hospital with 100 beds, half of which were designated for the poor.

The hospital opened on September 15, 1878, in unsuitable premises, and by 1890, a complex of buildings for the city hospital was constructed on the site of wine cellars. The main stone pavilion accommodated 70 beds, while two wooden barracks housed the rest. The stone building included wards with baths and sinks, as well as an operating room on the second floor. The commission recommended improving conditions for staff and patients, including relocating the outpatient clinic and operating room to separate buildings.

In 1892, two wooden barracks for infectious patients and other auxiliary buildings were constructed. The development of the hospital was made possible by the efforts of the senior physician Alexei Petrovich Minkh. In 1906, a maternity hospital was opened, built according to the design of architect Sterligov, initiated by Governor Pyotr Stolypin. Since 1911, the hospital became a training base for the medical faculty of Saratov University, which created additional pressure on its facilities.

In 1915, a request was submitted for the construction of a new building for 200 beds. Construction began that same year based on the project by Semyon Kalistratov. The new building was to include modern amenities and isolation for infectious patients.

Since 1918, the hospital has been named "1st Soviet." Today, it is the modern Saratov City Clinical Hospital No. 1, named after Yuri Yakovlevich Gordeev, who led it for 27 years.