Soon after Terrell State Hospital opened in July 1885, part of its property was set aside for the burial of patients who died while hospitalized. The first burial there took place on Oct. 22, 1885. The oldest gravestone is dated Jan. 19, 1888, but most of the graves are unmarked. A fence separates the cemetery's Jewish section. Some graves date from a smallpox epidemic in 1907. During the 1950s and 1960s, there were 30 to 35 burials a year, but the number gradually declined.