The purpose of this chapter is to discuss the design of acute care settings with a focus on the evolution of design practice over the last decade. In particular, ideas around healing environments describe how design is contributing to enhanced health and wellbeing and how recent developments are helping to create better designs. The chapter covers aspects of the theoretical hypothesis explaining the relationship between people, the environment and healing with a focus on three elements: how people perceive the environment, social interaction as part of healing and the influence of people's sociocultural background. The chapter looks at evidence-informed design in the context of acute healthcare settings whilst also covering trends, challenges and opportunities in healthcare design, and how this field is developing. A case study demonstrates elements of a real project on a before and after basis. The chapter concludes with the message that design of acute care settings involves much more than simply providing a space for care services to take place.