In recent years, scientific and bioengineering advances, Nobel prizes, an entirely new biotechnology industry, health policy research, oncogenes, prions, and the AIDS epidemic have placed UCSF in the forefront of the development of modern American biomedicine and medical education. Yet the school's long tradition reaches back to the very beginnings of the city of San Francisco in the Gold Rush days, and that society laid the foundations for the academic medical center that we know today. To reconnect this complex institution with its lively past, we have designed and written this narrative history, drawing upon the rich historical materials in UCSF's institutional archives and the work of the UCSF Campus Oral History Program.