The National Historic Preservation Act of 1966 and the New York State Historic Preservation Act of 1980 established the National and State Registers programs. The State and National Registers of Historic Places are the official lists of buildings, structures, districts, objects, and sites significant in the history, architecture, archeology, engineering, and culture of New York and the nation. Through Historic Saranac Lake's efforts, approximately 230 properties have been added to the National Register.

Name Description
Adirondack Railroad Historic District The New York Central Adirondack Line ran from Remsen to Lake Placid. There are seven extant structures in the Historic Saranac Lake district.
Berkeley Square Historic District Lying at the center of Saranac Lake's business district, the Berkeley Square District includes Harrietstown Town Hall and twenty-two commercial buildings constructed between 1867 and 1932 on South Main Street and South Broadway
Church Street Historic District The district comprises twenty-seven buildings including three churches, a medical laboratory, ten homes, two libraries, and six Cure Cottages, most built between the late 1870s and 1900; it runs from 57 through 118 Church Street and a short stretch of North Main Street
Cottage Row Historic District

The district includes twenty-seven buildings located between 61 Park Avenue and 185 Park Avenue; all are privately-owned, single family houses built between 1900 and 1940, the majority having been built between 1907 and 1917. Most of the residences were operated as commercial private tuberculosis sanatoria.

Helen Hill Historic District The district includes sixty-two buildings on Helen Hill built mostly between 1896 and 1930.  A majority of houses in the district housed commercial private sanatoria at the height of the cure era.
Highland Park Historic District The seventeen buildings of the district, located between 281 Park Avenue and 490 Park Avenue, are private, single-family homes built between 1896 and 1930, with the majority built between 1901 and 1910; it was an expensive enclave, home to millionaires, doctors, and other wealthy families, nearly all with one or more members suffering from tuberculosis.
Trudeau Sanatorium Historic District The first sustained, successful sanatorium for the scientific treatment of tuberculosis in the United States. Thirty-four contributing structures remain, including seven patient cottages, six residences for the medical staff, and six medical facilities.
Individual Cure Cottages In addition to the cottages located in historic districts, sixty individual properties located on Helen Hill, French Hill, Glenwood and Rockledge are listed on the National Register.
Paul Smith's Electric Light and Power and Railroad Company Complex Built in 1927, the building was the headquarters of Paul Smith's Electric Light and Power and Railroad Company, the family corporation's major operations apart from Paul Smith's Hotel, all run by the only survivor, son Phelps Smith.
Will Rogers Hospital Built in 1928-29, originally named the NVA Hospital was an offshoot of the efforts of the National Vaudeville Association's efforts to provide subsidized care to aging and unwell vaudevillian performers.
Other Recognized Historic Properties Properties listed on the National Register of Historic Places or National Historic Landmark properties outside of the village of Saranac Lake

There are many historic houses in Saranac Lake that are not on the National Register. You can find them on the pages of Roads, Streets and Avenues.