The Hospitallers in Jerusalem and the Holy Land: A Religious Order of Care and Defence

The Hospitallers began as a religious community caring for pilgrims and sick people in Jerusalem, before developing into an order that combined charitable work with the defence of the Christian states established in the eastern Mediterranean after the First Crusade. Their history in the Holy Land runs from the hospital’s origins in the late 11th century through papal recognition in 1113, the gradual growth of their military responsibilities, and the loss of their Levantine headquarters at Acre in 1291. The order’s charitable and military functions remained connected: its hospitals served people in need, while its estates, buildings, and armed members helped sustain its work and protect its interests.

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A hospital in Jerusalem before the First Crusade

Before the First Crusade, the Hospital of St John operated alongside the Benedictine abbey of St Mary of the Latins in Jerusalem. Merchants from Amalfi had supported the monastery, and Benedictine monks cared for Christian pilgrims travelling to the city’s holy places. In the late 1060s, the community established hospitals for men and women; the men’s hospital became known as the Hospital of St John. In the Middle Ages, a hospital could provide shelter and care as well as treatment.

Gerard, remembered as the founder of the Hospitallers, was probably a Benedictine lay brother. By about 1080, he was overseeing the Hospital of St John, though little is known securely about his origins or early life. The hospital’s work therefore preceded both the Crusader conquest of Jerusalem and the creation of the religious order. The order grew out of this existing charitable institution.

The conquest of Jerusalem by the First Crusade in 1099 changed the hospital’s political circumstances and brought it new patronage. Gerard and other brothers continued their work, and the hospital received gifts of property and revenue from rulers and churchmen. These resources helped it expand beyond the city. Houses and hospitals in ports and other places used by pilgrims linked the Jerusalem institution to routes across the Mediterranean.

Papal recognition and an independent order

On 15 February 1113, Pope Paschal II issued the bull Pie postulatio voluntatis, formally recognising the Hospital of St John as a religious order. The bull placed the institution under papal protection, confirmed its right to receive and hold property, and allowed its brothers to elect Gerard’s successor. It also granted exemptions from tithes on the order’s lands. A tithe was a levy collected by the Church, often on agricultural produce or income. Recognition gave the hospital greater independence from the monastery and local church authorities, while keeping it under the authority of the pope.

The order’s leadership and identity developed over time. Gerard was described as rector of the hospital; his successor, Raymond du Puy, helped shape the institution in its early decades. The brothers’ religious community remained central even as their work grew. The Hospitallers received gifts from rulers and private benefactors, and the order established houses in Europe as well as the Holy Land. These outposts could support pilgrims travelling east and provide income and personnel for the Jerusalem institution.

The order’s charitable purpose extended beyond assistance to pilgrims. Later descriptions of its Jerusalem hospital say that sick people were admitted regardless of nationality or religion, including Muslims and Jews. Accounts from the 12th century convey the scale of the institution, although the figures they give are not consistent. Food, beds, attendants and religious support sustained this large charitable household.

From care to the defence of pilgrims and the kingdom

The Hospitallers’ military role emerged gradually. The 1113 papal bull recognised a religious hospital order, not a fully formed military force. In the following decades, the order arranged armed protection for pilgrims and developed its own capacity to defend people and territory. Evidence points to this change taking shape during the 1120s and 1130s. A charter from 1126, for example, records a brother with a military title, while later evidence refers to armed men protecting pilgrims.

Defence became an institutional responsibility alongside care. Under Raymond du Puy, the order developed a military organisation, and by the middle of the 12th century the Hospitallers were receiving castles and other strongholds to defend. In 1136, King Fulk of Jerusalem entrusted them with Bethgibelin, a castle that helped guard roads linking Ascalon and Hebron. In 1142, they received Krak des Chevaliers in the County of Tripoli. Such responsibilities involved more than fighting: castles needed garrisons, supplies, repairs, and, at times, new building work.

The order’s members came to include brothers serving as priests, knight-brothers, and sergeant-brothers, though the categories and their formal recognition developed over time. These roles allowed the order to combine religious services, hospital work, administration, and armed defence. The military work did not replace the hospital’s original purpose. Instead, the two functions drew on the same institutional base of people, property, and income.

Property, income, and the order’s network

Donations of land and revenue were essential to the order’s ability to maintain hospitals, houses, and military posts. Rulers and local nobles gave it property in the Kingdom of Jerusalem and elsewhere. In 1113, papal recognition confirmed the order’s rights over its holdings and revenues; the Hospitallers’ network also grew through gifts and houses in European regions connected to pilgrimage. Over time, the order organised its properties through priories, bailiwicks, and commanderies. A commandery was a local house or estate that formed part of the order’s wider administration.

These holdings served several purposes. They could supply income, provide lodging for travellers, and support the brothers and armed forces. The relationship between charitable work and property was practical: hospitals required buildings and provisions, while military responsibilities required men, equipment, and defended bases. The order’s network beyond the Holy Land helped sustain a presence in the region even as individual territories and strongholds changed hands.

Jerusalem lost, Acre becomes the headquarters

The Hospitallers had a presence in Acre from the early 12th century. In 1110, King Baldwin I confirmed their right to buildings there. Their complex grew over several building phases and included a church dedicated to St John, a hospital, and spaces for administration and accommodation. The buildings were connected to the life of the city as well as to the order’s internal needs. Wells, cisterns, storage areas, and drainage formed part of the infrastructure required to keep a large religious and charitable house operating. The remains at Acre show how hospital, religious, administrative, and defensive functions could be brought together in one urban complex.

Jerusalem fell to Saladin in 1187. When Crusader forces retook Acre in 1191, the Hospitallers returned to their buildings there, and Acre became the order’s headquarters in the Holy Land. The commandery, meaning the order’s main institutional house in this context, was expanded during the 12th and 13th centuries. It accommodated the central administration and, from 1271, the master of the order. Acre also became the principal setting for the order’s work in a kingdom whose political centre had shifted away from Jerusalem.

The fall of Acre and departure from the Levant

By the late 13th century, the Hospitallers’ position in the Levant had become increasingly precarious as Mamluk forces captured Crusader strongholds and territories. Acre fell to the Mamluks in May 1291 after a siege of 44 days. The city’s fall ended the Hospitallers’ headquarters in the Holy Land. The surviving order withdrew to Cyprus, where it continued beyond the Levant. This relocation marked the end of its Jerusalem-and-Acre period, not the end of the institution that had grown from the Hospital of St John.