Regulation of the practice of medicine and allied professions in the Republic of South Africa began in the late 19th century. The Colonial Medical Council of the Cape Province was founded in terms of section 18 of the ‘Medical and Pharmacy Act’ of 1891. The first meeting of this council took place on 4 January, 1892. In Natal, the ‘Natal Medical Council’ was established in terms of section 18 of the ‘Medical and Pharmacy Act’ of 1896 and the first meeting was held on 9 October, 1896 in Pietermaritzburg. The 'Medical and Pharmacy Council of the Orange River Colony resulted from Ordinance 29 of 1904.

The HPCSA’s origins date back to 1928 when, in accordance with Act 13 of 1928, the South African Medical and Dental Council (SAMDC) was appointed to fulfil the functions of the four former provincial councils. Act 13 of 1928 made provision for two statutory councils: the South African Medical Council (SAMC) and the South African Pharmacists' Commission (SAPC). The SAMC was also responsible for the registration of nurses until the South African Nursing Council (SANC) was established as a separate council in 1944. Likewise, the registration of dental technicians was the responsibility of the SAMC until the formation of the South African Dental Technicians' Council in 1945.

Act 56 of 1974 replaced Act 13 of 1928, in terms of which the SAMDC, now renamed the HPCSA, continues to exist as a separate legal entity. The first meeting of the Council was held on 22 October, 1928 in Pretoria and was opened by the late Dr. D F Malan, the then Minister of National Health and later the fourth Prime Minister of the Union of South Africa. Although Act 13 of 1928 made provision for the South African Medical Council and the South African Pharmacist’s Commission to exist as two statutory councils, these two Councils had a common Registrar for a number of years.

In 1947, the first register of medical deputies was established. Attempts aimed at making registration of these professions, later paramedical and supplementary health service professions, compulsory, have a history of its own. After a variety of draft bills and elected Committees of Parliament, Act 13 of 1928 was amended in 1971 to make provision for the establishment of professional boards registered with the Council. Professional Boards for Physiotherapy, Optometry, Medical Technology, Chiropody (Podiatry), Health Inspectors, Occupational Therapy, Psychology, Radiography, Medical Orthotists and Prosthetists, Speech Therapy, Audiology, Dietetics, Oral Hygiene, Opticians and Clinical Technology were established. More professional Boards were established at a later stage while others were amended or combined as necessary.

Section 4 of the Health Professions Act was amended by the Health Professions Amendment Act, 2007 (Act No. 29 of 2007 by introducing a requirement for the exercise of the powers of Council to be in line with the National Health Policy as determined by the Minister.

The amendment marked the launch of a new era in the history of medical and health regulations – stepping stones to a brighter future in health care for all.

Today, the HPCSA, in conjunction with its 12 Professional Boards, is strongly committed to promoting the health of the population, determining standards of professional education and training, and setting and maintaining excellent standards of ethical and professional practice.