Ellerbe designed the world's first private practice clinic – the Mayo Clinic in Rochester, Minn. Still a client today, Mayo represents Ellerbe Becket's oldest and most-enduring relationship.

Tom Ellerbe's own experiences as a hospital patient led him to urge a radically new approach. He proposed to the Cleveland Clinic the then revolutionary concept of equipping each hospital room with a private toilet and lavatory facility. The Cleveland Clinic demonstrated so conclusively the advantages of private toilets (improved sanitation and patient comfort, savings in nursing time) that Ellerbe's idea soon was adopted as standard design by hospital planners.

During World War II, Ellerbe designers overcame the scarcity of structural steel by using laminated pine arch-trusses to span 30-meter-wide hangars for the then Northwest Orient Airlines. They were the largest laminated wooden trusses in the world.

Ellerbe was the first architectural and engineering practice in the U.S. to acquire modern computer technology. "This alone makes Ellerbe Becket the longest-standing appliers of computer aids to the practice of architectural design," said Massachusetts Institute of Technology Professor Nicholas Negroponte.

Ellerbe designed the first single-structure complex in the U.S. built with both public and private sector financing. The Lexington Center in Kentucky, built in the 1970s, combined an arena, an exhibition hall, a hotel and a shopping mall.

Notre Dame offered the first college building in the U.S. to serve multimedia technology remotely. Ellerbe Becket's design in the early 1990s was acknowledged by the Association of International communications Industries with an award for innovative design.

Chase Field (originally known as Bank One Ballpark) was the first U.S. stadium with a retractable roof. The relatively simple technology used for moving the roof – borrowed from the 19th century seaport shipping industry – has proved to be the most reliable of all the retractable roof systems.

At the dawn of the new millennium, Ellerbe Becket designed the first convertible dome IMAX theater in North America. Giant mechanical arms rotate a nine-story display, switching between a flat and domed screen at the Science Museum of Minnesota.

Ellerbe Becket has become the leading healthcare designer in the Middle East with major projects throughout the region.