The idea for the National AIDS Memorial Grove was conceived in 1989 by a small group of San Francisco residents representing a community devastated by the AIDS epidemic, but with no positive way to express their collective grief. They envisioned a serene place where people would come alone or in groups to hold memorial services, to remember among the rhododendrons and redwoods. It was to be a place dedicated to all lives touched by AIDS—those who had died, and those who were left behind. As news of the Grove initiative grew, so did support and interest.

The group selected the de Laveaga Dell in world-renowned Golden Gate Park as the site for the Grove. Due to park budget cuts and lack of funding, the Dell had fallen into a state of disrepair for more than 40 years. It was overgrown and unusable by the public. A team of prominent architects, landscape architects, and designers volunteered to create a landscape plan that would be fitting as a timeless living memorial. The Grove's board of directors obtained a 99-year renewable lease with the City of San Francisco to create and maintain the Grove. An endowment has been established to cover costs of a gardener and ongoing maintenance.

Site renovation began in September 1991, and is still in progress through monthly volunteer Workdays. Since 1991, volunteers have donated more than 60,000 hours clearing overgrowth and reintroducing native species by planting new trees, plants, and shrubs.

In October 1996, a historic milestone was reached when Congress and the President of the United States approved the National AIDS Memorial Grove Act. This official designation gives the Grove a status comparable to that of the Vietnam Veterans Memorial, Mount Rushmore, and the USS Arizona at Pearl Harbor. As the AIDS pandemic continues to invade humanity in unprecedented numbers, the establishment of the Grove as the national gathering place for healing, hope, and remembrance also serves as an important marker in the history of this dreadful disease.

The Grove exists in large measure because of the generous contributions from individuals, philanthropic foundations, volunteers, and corporate patrons. The board of directors has held firm to its commitment that the Grove receive no federal funding, preferring instead that all government funds earmarked for AIDS continue to support AIDS care, research, and treatment programs.