Ellis Island was originally a military fort in the middle of New York Harbor. It was named after the War of 1812 Fort Gibson. For the first 100 years of American history the states were responsible to process new immigrants. New York had processed its immigrants at the Castle Garden Immigration Center located in lower Manhattan. In 1890 the Federal government assumed responsibility for processing immigration and the Federal government appropriated many to establish the first Federal immigration center on Ellis Ave. The island was doubled in size from 3 to six acres. On January 1,1892 the immigration center was opened. During its first year over 400,000 immigrants were processed through the center. By the time the center closed it had processed over 10.5 million immigrants.

Immigrants when they arrived were asked 29 questions including if they had money to support themselves. If they passed the questionnaire the immigrants then underwent a quick medical examine paying special attention to the possibility that the immigrant had trachoma. If the initial inspection showed any possible problems the medial staff who were all military doctors would conduct a more extensive examination. 2% of the those arriving at Ellis Island seeking immigration to the United States were turned back and not allowed entry.