This is an overview of the process by which immigrants entered the U.S. via Ellis Island. Just like today, the process was arduous and a difficult experience (in a different way), however one thing that made it easier was that most of the restrictions on entry were based on the immigrants’ health status. The percentage of returned immigrants was at mere 2% of those that arrived. Quite a different story from today.
The overview was copied in its entirety from here.
You can also view a great presentation covering the history of immigration to the US at the Ellis Island foundation website.
Immigrants endured an ocean voyage from eight to more than twenty days—generally in cramped, unhealthful steerage—making their arrival at Ellis Island a victory of sorts over the conditions of passage. Some wore tags of identification stating their ultimate point of U.S. destination. All had passports and other papers detailing information about themselves. Second- and third-class passengers were usually processed and on their way before those in steerage. Many of the new arrivals were young adults clutching the hands of children and carrying babies. Most had all their earthly possessions in a “bundle” (a makeshift sack or blanket) or a suitcase. Few expected ever to return to their homelands. Their reasons for coming to the United States were as varied as the people themselves.
Having secured passage from places such as Hamburg or Liverpool, immigrants usually booked one-way passage with the expectation of staying. If they were detained or forced to return by authorities at Ellis Island, steamboat companies bore the expense. The percentage of returnees was about 2 percent, or sometimes up to one thousand a month. Detainees with medical problems were chalk-marked “E” for eyes, “L” for lameness, or “X” for mental disability. If not sent back, detainees sometimes remained quarantined for days or weeks at Ellis before moving on to their American destinations.
Upon disembarking, immigrants were directed toward a large building where they immediately entered the gigantic, sixty-foot high Registry Room. Here they underwent a quick medical exam followed by a review of their traveling papers and some legal questions, such as age? destination? employment? Most cleared this process in five hours and left for their ultimate destination the same day. Those who were detained were suspected of trachoma, a highly contagious eye disease causing blindness, or “loathsome and contagious” diseases such as tuberculosis, measles, or favus, a scalp and nail fungus. These people went upstairs to the second floor for closer examination by trained medical personnel from the U.S. Public Health Service. Breathing difficulties, lameness, or abnormal posture could be observed on stairways by observant health care workers.
The medical facilities included a 275-bed hospital, contagious disease wards for 450, X-ray facilities, laboratories, and a morgue. Between 1900 and 1954, 355 births and 3,500 deaths (1,400 of them of children) were recorded. In 1924 alone the record showed nearly fifty surgical procedures performed monthly.
Once past medical inspection, immigrants joined one of many lines to answer remaining questions. Here in the span of about two minutes inspectors decided whether to admit the immigrants into the United States. It was not unusual for inspectors to work twelve-hour shifts during the peak immigration period from early spring to late fall. Sometimes immigrants without sufficient money would have to wait for the arrival of a relative or funds before leaving, but generally five days was the maximum stay at Ellis Island. Additionally, circumstances prompted boards of inquiry to ascertain why some immigrants were migrating and to determine whether they should be detained or deported. Alerts about criminals wanted in other countries, suspicion of contract laborers, or simply the fear that extremely poor people would become public charges were common.
The processing experience seemed inhumane at times because of the sheer numbers, but most of the commissioners in charge tried to move the people through as quickly as the ever-tightening immigration laws allowed. Beginning with legislation in 1924, more processing took place at the point of departure, making the job less tedious for American inspectors. For the approximate 20 percent who failed immediate clearance and required detention, fourteen dormitories organized by gender were equipped with canvas or wire mesh mattresses for sleeping. The dormitories accommodated up to fifty people and lined the balcony overlooking the registry room. A large dining room served meals on a continual basis to both those passing through and those detained. Over twenty years the island grew to become a miniature city where a staff of seven hundred doctors, nurses, interpreters, matrons, clerks, maintenance workers, and night guards worked up to twelve-hour days, seven days a week. Groups such as the YMCA, Red Cross, and Salvation Army assisted by serving coffee and donuts, providing used clothing, and helping find lost luggage, wandering children, and mainland relatives. Holidays were observed with special events such as parties produced by the welfare groups.
Ellis Island served as a transition place for thousands of immigrants. Marking the division between their past and their unknown future, processing at Ellis Island was an experience few ever forgot. Once the experience was complete, a barge took new arrivals to Battery Park at the tip of Manhattan where they were met by relatives, directed to sites within the city, or sent to train stations to connect with points throughout the United States. While many lived out the remainder of their days in New York, many others went to Philadelphia, Boston, Chicago, and other cities. Thousands more headed for the farmlands of Iowa, Nebraska, and Kansas.