Carilion is the region's major hospital complex and the city's largest employer. The huge Carilion complex began with the fourteen-story East Pavilion, a brick building pierced by narrow vertical bands of windows. This older section abuts the more recent West Pavilion with its green-glass walls. The two parts are tied together by a long canopied arrival area clad with sections of rough-faced and polished marble in front of a spacious skylit interior atrium. In the West Pavilion, many of the patients' rooms have fine views of the city, as do the offices in the building's rounded ends.
The Carilion complex has expanded across S. Jefferson Street SW with the construction of a large Cancer Center as well as a Medical Building and Clinic. A huge biomedical complex just across the Roanoke River from the hospital includes a clinic as well as the Virginia Tech Carilion School of Medicine (2010, HSMM AECOM) at Riverside Circle. Like the hospital, the school is also a brick structure with a curved section of green glass. Here, however, the ground floor is faced with Hokie stone, thereby making a nod to the traditional limestone building material of Virginia Tech (MO17), Carilion's partner in the medical school.