Pier 43 and its headhouse, a decorated hoisting tower for loading and unloading rail cars on and off ferries, was built in 1914 to serve the Belt Railroad.

The wood pier was replaced in 1996. The headhouse was rehabilitated in 2002-2003 to the Secretary of the Interior's Standards after a fire in 1998.

Pier 43 contributes to the Port of San Francisco Embarcadero Historic District which was listed on the National Register of Historic Places in 2006.