The United States Civil War was the most gruesome conflict fought on United States soil. The mass influx of injured soldiers requiring care forced the Union and Confederacy to evaluate and adapt their traditional medical practices in an attempt to care for this population. Armory Square Hospital, a Union hospital in the heart of Washington D.C. and Chimborazo Hospital, a Confederate hospital in the Confederate capital city of Richmond, VA were each established in an attempt to care for this massive number of injured patients. This study compares the experiences seen at these two hospitals and provides reasoning behind the overall success to treat patients at these two hospitals.