Abstract: The period of significance for fourth generation of Veterans Administration (VA) medical centers ranges from 1955 to 1977. This period encapsulates a surge of VA medical center construction with congressional funding, dating from the release of the 1955 congressional report Nonbed Betterments in Veterans Administration Hospitals—Need for Renovation and Construction to the adoption of the Veterans Administration Medical Facilities Acquisition Act of 1977. New medical centers constructed by the VA during this time may be eligible under Criterion A for their association with health care and medicine, specifically the development of education and research relationships with medical schools. These partnerships advanced therapies, technology, and hospital operation in support of the VA’s mission to provide quality medical care for veterans. To support these partnerships, VA medical centers were commonly built adjacent to or within medical school complexes. Additionally, fourth generation VA medical centers may be eligible under Criterion C for embodying distinctive architecture or landscape architecture characteristics of mid-century modern hospitals or representing an important contribution in a significant architect’s career. This report provides a comprehensive historic context for the design, construction, and operation of new fourth generation VA medical centers in support of Section 110 of the National Historic Preservation Act of 1966 (NHPA). It does not include other VA medical facilities constructed during this period, such as psychiatric and rehabilitation centers, nursing homes, domiciliaries, and research and education buildings.