The concept of a caring Christian ministry, which resulted in the founding of Augsburg Lutheran Home, began at a social gathering of Lutheran women in 1892. At her birthday gathering, Mrs. Charles J. Lang voiced her concern about a lack of care for two homeless children. Her idea of a church-sponsored refuge for children and the aged was enthusiastically received and friends from Martini Lutheran Church provided the first contributions toward that goal. This first gift of three dollars became known as the Augsburg Acorn. The ministry quickly expanded to include care for the aged.

Augsburg's first building, purchased in 1893, was located at 746 West Lexington Street in downtown Baltimore. The Ladies' Society donated more than $1,000 for improvements to the newly purchased building and a year later, in 1894, a new addition was completed. A further addition was made to the home in 1902.

In 1920, a 41-acre tract was purchased on Campfield Road. A new facility with a capacity of 35 adults and 60 children was dedicated in late 1929.

Further expansion of Augsburg came with the dedication of a nursing care wing and chapel in 1949. In 1959, 10 more resident rooms, a nursing station and a solarium were added. Orphan care was discontinued in 1969 and the children's wing was remodeled in 1973 to provide 22 additional nursing care beds.

Augsburg has grown significantly during the last three decades. The purchase of 10.7 acres increased the rural campus and in 1987, Augsburg Lutheran Village was dedicated, providing 61 Retirement Living apartments. The Village was planned to provide gracious retirement living in a secure rural setting.

The West Wing Health Center opened in February 1989. A three-story complex, the Health Center added 60 skilled nursing care beds, a new kitchen, dining facilities for Augsburg Lutheran Village residents, and an activity room. Augsburg subsequently added two, two-story buildings; including 35 Retirement Living apartments and 64 West Wing Health Center beds along with an expanded kitchen. In 1999, the final phase of the expansion program added 38 Assisted Living residence.

The 21st century brought additional changes to expand services and increase Augsburg’s ability to provide long-term continuous care at affordable rates. Assisted Living residences now total 58, and in August 2006, Reformation Square opened, adding 42 apartments, and a Town Center featuring a café, wellness suite, fitness room, and beauty salon.