The United Hospitals Challenge Cup is contested by the six medical schools in London and is most notable for being the oldest rugby cup competition in the world.^[1]

In 1874 the United Hospitals RFC instituted a cup competition, the "United Hospitals Challenge Cup", also known as the "Inter-Hospital Challenge Cup". The first final was played on Wednesday 3 March 1875 at The Oval, which had also been the site of England's first home rugby international three years earlier. The match predated by four years the first Calcutta Cup match and is the oldest cup competition in the game of rugby. The first final was contested between Guy's Hospital and St George's Hospital in front of 400 spectators. Guy's, wore an orange and blue kit, and kicked the game off, whilst their opponents wore green jersey, green shorts with brown socks. Guy's won but St George's got their revenge the next season. When this game was played matches were won by goals rather than points. A goal was a converted try, and tries themselves only value in the case of a draw in which case they would be counted up as the deciding factor. Guy's Hospital won the game by 1 Goal (a converted try) and 1 try to 2 tries. The records say that the three additional 'tries' were all defensive touch downs. The game was also notable for fielding 15 players per side at a time when all international matches, the Varsity Match, County matches and all other top level games were being played with 20 players per side and would continue to do so until 1877. In this regard, the United Hospitals RFC was a pioneer. With the exception of breaks for the two world wars of the twentieth century and COVID-19, the United Hospitals Challenge Cup has been played for without interruption since that first final.

The Royal Veterinary College was invited to join the competition for the first time after a vote was taken during the AGM on 13 May 2008.^[2]

The current holders are Barts and the London RFC who beat GKT 22-12 at The Rock, Rosslyn Park F.C.’s ground in Barnes in March 2022.

• List of oldest rugby union competitions
• Rugby union trophies and awards