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Introduction: Since its establishment in 1304 to now (1394), the health system in Iran has witnessed many changes and developments, it has had successes and improvements in many areas, and it has performed unsuccessfully and beyond expectations in some areas, and knowing the reasons for them can Explain some of the issues and challenges of health policy in the country.
Method: The current research, within the framework of the institutional approach and using the path dependence model, seeks to examine important and influential events on the evolution of the health institution. The research method is historical and the required information has been collected by referring to historical texts about the health system and its sub-sections.
Findings: According to the results of the research, the focal point of the formation of the health system in Iran goes back to the establishment of Dar al-Funun in the Qajar period; Then, in the course of its developments, three main historical moments can be identified: the victory of the constitutional revolution and the formation of the National Council, the establishment of the Pahlavi government, the victory of the Islamic revolution and the establishment of the Islamic Republic. In each of these periods, according to the course of events and the goals of the governments, changes in health policies have taken place, the results of which have been manifested in the current health system of Iran.
Discussion: Dependence on oil income, low budget of the health sector, and weakness of the government’s health policies are among the long-standing features of the health system in Iran. which have made it a challenge to achieve the main goals of social policy, i.e. modernization and expansion of justice, and health policy has been affected by it, like other sub-sectors of social policy.

Keywords: Health system, Path dependency, social policy, institutionalization

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