PurposeTherapeutic landscapes can be beneficial for patients recovering from cognitive and behavioural impairments. The therapeutic garden in the Royal Talbot rehabilitation centre (RTRC) located in Kew, Melbourne is a precedent for its nature design outdoor spaces and horticultural therapy (HT) program for patients with cognitive impairments due to brain and spinal cord injuries. There have been no studies into the physical design of the RTRC therapeutic garden.Design/methodology/approachThis case study unveils the critical design themes, and dominant physical elements of the RTRC therapeutic garden through site observation and analysis over the course of two months, a semi-structured interview with a key staff, and graphical representations using integrated photography and collaborative digital tools of AutoCAD and Adobe Photoshop.FindingsSeven critical design themes are identified for the RTRC garden: (1) space layout and organization, (2) physical and visual access, (3) pathway and facility, (4) multisensory vegetation, (5) amenity, wayfinding and seasonal interest, (6) cognitive stimulation, (7) utility and HT. Qualitative and quantitative data analysed in visual and descriptive format reveal multisensory vegetation, amenity, wayfinding and seasonal interest, and utility and HT are the top three most pivotal critical design themes in the RTRC therapeutic garden.Research limitations/implicationsThe findings of this case study can be used to impart knowledge about the design of therapeutic landscape settings for cognitive impairments to design professionals and the public.Originality/valueThere is no case study has been conducted for this precedent of therapeutic garden in the Royal Talbot rehabilitation centre that targets for cognitive impairment patients. With the increasing awareness in medical and healthcare environments, this case study would help to inject mutual understanding, generate knowledge and design awareness among design professionals and public, and to cultivate more good quality healthcare settings.