Otter Island 45th PA Regiment Hospital Cemetery is a Civil War burial ground for the regimental hospital established by Otter Island Union occupation forces. At the outbreak of the Civil War, the Confederate States of America built earth work fortification on Otter Island named Fort Heyward. However, with the fall of Port Royal Sound and the appearance of Union gun-boats, they abandoned their fortification. Union Naval Forces scouted out the island, found the abandoned CSA fortification and recommended occupation. Companies B, F, G, H and K of the 45th Pennsylvania Infantry Regiment took occupation on Otter Island on 11 Dec 1861. They were joined by Battery I, 3rd Rhode Island Heavy Artillery Regiment, to mount and man five guns. During that time, the units enhanced the fortifications renamed Fort Drayton. They built artillery emplacement, commissary, guard house, supply wharf, and regimental hospital. They carried out small military and food foraging operations in the surrounding area, such as Seabrook Island, but most of those dying in the hospital died of disease as recorded in the Wellsboro Agitator newspaper (Tioga County PA); History of the Forty-fifth Regiment, Pennsylvania Veteran Volunteer Infantry, 1861-1865; and the United States Registers of Deaths of Volunteers, 1861-1865. The 45th PA Inf departed on 21 May 1862 on the steamer Potomac. Company G returned briefly on 28 May 1862 to bury five cannons in the area of the fortifications. The troops recalled boredom and sand fleas tortured them the most during their stay and they looked forward into getting into the fight.
The area remained abandoned again until Oct 1863, when elements of the 1st NY Engineers Regiment erected and maintained a signal tower to relay messages up and down the coast. Review of their unit history reveals no deaths on Otter Island. An Army General Hospital was established at Hilton Head Island to treat their ill and injured.
In 1986, Dr. Harvey S. Teal visited the uninhabited island and discovered the graves with a metal detector. As of 2013, the graves have not been relocated to a National Cemetery.
The cemetery has no markers, no deed, and public access is limited to day use permits using a boat. Beware of hunting seasons and wear hunter's orange.