The Genesis of NIMS dates back to the year 1961. The Nizam's Charitable Trust thought of starting a speciality Hospital for orthopaedic patients with an initial investment of Rs.55 Lakhs. The foundation stone was laid on 16.07.1961 by Sri Morarji Desai, Minister for Finance, in the cabinet of Sri Jawaharlal Nehru,   the first Prime Minister of India.

The Nizam's Orthopaedic Hospital was inaugurated by Sri S.K.Patil, Union Minister for Railways and was declared open by Her Highness, the Princess of BERAR on 22.12.1964.

The Nizam's Charitable Trust gave the hospital to the Government of Andhra Pradesh on lease for a term of 99 years on 13.02.1976. The hospital was renamed as Nizam's  Institute of Orthopaedics and Specialities and was inaugurated by Sri Jalagam Vengala Rao, Chief Minister of Andhra Pradesh on 31.03.1976.

The Govt. established the Institute of Medical Sciences on 11.03.1980 as an autonomous body registered under A.P. Public Societies Registration Act. This was inaugurated by Dr.M.Chenna Reddy, Chief Minister of Andhra Pradesh on 17.03.1980.

With the objective of developing into a full fledged super speciality hospital for patient care, research and training, the Govt., transferred NIOS to IMS on 25.03.1986 under the name of Nizam's Institute of Medical Sciences, during the tenure of Sri. N.T.Ramarao, Chief Minister of A.P, with Prof. Dr.Kakarla Subbarao as the first Director.

With the objective of further developing the educational and research facilities in the field of medical sciences in super specialities and to develop  a pattern of teaching in post graduate level including training in para medical and allied fields, the Andhra Pradesh State legislature passed a bill  making NIMS a university. The Act came into effect from 18.06.1989 and NIMS was recognised by the University Grant Commission, Medical Council of India, Royal Society of Radiologists of UK.