The Lambeth Asylum was designed by the architect Arthur Hayes, his first and only project, in 1850. Unlike other hospitals, the asylum was largely undocumented with its records of treatment administered there vague. The hospital was financially supported by the Templars.
Sometime during the 19th century, the Templar John Elliotson who worked in the asylum distributed the drug Starrick's Soothing Syrup to its patients. Elliotson also conducted brutal experiments such as electrocution. By 1868, the Assassin Jacob Frye infiltrated the asylum to assassinate Elliotson.
Not much later, Jacob's twin sister Evie Frye and young accomplice Clara O'Dea visited the asylum to find a cure for Babylon Alley's children. Clara herself had gotten the disease and, with the nurse Florence Nightingale, Evie managed to find the cure.
However, following the assassination of Lambeth Asylum's only benefactor, businessman Crawford Starrick, the hospital closed its doors in January 1869. Jacob Frye recruited at least one of the inmates of the asylum into the Assassin Brotherhood.
Two decades later, this inmate would commit the Whitechapel murders, becoming widely known as Jack the Ripper. When he found his Terror challenged by Evie Frye, who had recently returned from India, Jack traveled to the asylum to assassinate his old doctor and nurse, as well as the director of the facility, burning all the records of his existence.
He then freed the inmates of the G Wing, which were all notoriously violent criminals, as part of his plan to ambush Evie. Eventually, the two Assassins confronted each other in Lambeth's basement, where Jack had previously locked Jacob Frye up as well. Evie managed to defeat and kill Jack and free Jacob. With the help of Inspector Abberline, they made sure no one ever learned of what had transpired, making Jack the Ripper into the mystery that he is.
- Lambeth Asylum is a fictional asylum which appears to be an amalgamation of several real life institutions. Its location and the experimentation with patients appears to be based on the Bedlam asylum. The cental tower is based on the tower of the real life St. Pancras station which ironically is fictionalized in game. The two smaller towers are based on the Royal Albert Hospital.
- There are light bulbs inside the asylum, though this is anachronistic as electric light was first used in Holborn in 1883.