Alexandra Gate and former Royal Alexandra Infirmary, excluding later flat-roofed section to north, Neilston Road, Paisley

The building is a two- and three-storey and attic former hospital, dating from 1897 to 1900, designed by the Paisley architect Thomas Graham Abercrombie. It is roughly E-shaped and built in the Scottish Renaissance style. The main entrance is on the north side, with a linking corridor connecting to three pavilion arms to the south. The building is constructed of snecked and stugged red sandstone with ashlar margins, incorporating a variety of window types including transomed and mullioned windows, alongside rectangular openings. The eastern pavilion was converted into flats in the 1980s and is now known as Alexandra Gate; the remainder of the building was unused in 2017.

A section to the north, with a flat roof, is excluded from the listing.

The rear of the building has an advanced, roughly square-plan, three-bay entrance section, accessed by a main entrance door on the west side. The west elevation features a central, round-headed doorpiece flanked by paired Ionic columns, topped with a broken, segmental pediment. Corner turrets with attached columns and finialled bellcast lead caps are present at the northeast, northwest, and southwest corners. A square tower with a corbelled parapet and bartizans rises from the southwest corner. A two-story passage with seven round-headed arches connects the central section to the west pavilion.

The east elevation of Alexandra Gate features two advanced, three-windowed gabled bays flanking a corbelled and canted oriel window rising from the first floor. Above is a round-headed arch with a parapet, which incorporates a veranda with a central column. The north end of Alexandra Gate includes a large circular former ward with pedimented windows at ground level and elaborate pediments to the attic dormers, topped with a conical roof and a bellcast capped ventilator.

The south end of each pavilion arm has semi-circular, railed verandas with ashlar Roman Doric columns supporting the ground floor and cast-iron columns on the first floor, with conical roofs. These verandas are flanked by projecting square bays with piended roofs.

The north end of the west pavilion arm exhibits rounded corner turrets with pedimented dormers and conical slate roofs.

Windows are timber sash and case with plate glass glazing, or timber plate glass casement windows. The roofs are primarily green slate, with some piended and gable sections. Louvred ventilators are largely octagonal, featuring bellcast or facetted lead caps.

Interior spaces within Alexandra Gate, viewed in 2016, have been converted into modern flats, showcasing wide, dog-leg staircases with decorative metal balusters and timber handrails.