Urban growth in today’s development is an obstacle in providing the sustainable environment. Hospital as care facility takes an important and critical role in a livable environment for the users by its green building services. In conservation strategy, the building should concern on integration preserving the heritage value and planning of all care utilities. Therefore, this research reviews for sustainable and livable heritage hospital and were conducted through research phases as follows: Existing review, sustainable and green planning for critical building services, and environmental analysis using Ecotect Analysis and Matlab software environmental simulation. Dr. Soetomo Hospital is selected as the urban heritage object case. The results highlighted that the urban hospital should have design routes for building services integrated with mass management and architectural concepts as well as landscape design, and standardization of planning and system component life, designing the inner and/or outer rings will be potential planning. By conducting on to the existing high-density buildings evaluation, the building services master plan remains to be used is the zoning system pattern related with heritage conservation strategy. To anticipate the future projection, it is necessary to adjust the environmental performance because the utility system should accommodate the respective heritage for the requirement of facilities, capacity, and technology of green hospital concept.