The cult was known between the 7th and 6th centuries BCE as a local cult. It spread out after the recognition through the oracle of Apollo at Delphi and after the catasthrophic plagues in 429 and 427 BCE in Athens and in 293 BCE in Rome. The oldest Asklepieion seems to be at Trikke (the present day Trikala in Thessaly), while the biggest centres of worship were established in Epidaurus, Corinth, Cos and Pergamon. Pausanias noted some interesting details about offerings to Hygieia at the Asklepieion of Titane in Sikyonia, which was founded, according to him, by Alexanor the grandson of Asklepios. The statues of Health were covered by masses of women's hair consecrating to the goddess and the swathes of Babylonian clothing. The same offerings are also known from the inscriptions discovered in the Cycladic island Paros.
Hygieia was sung and represented by many artists from the 4th century BCE until the end of the Roman period. Ariphron, the Sikyonian, who lived in the 4th century BCE, was the author of a hymn celebrating her. The statues of Hygieia originated from well-known masters like Skopas, Timotheos (both of these works at the present time in the National Archaeological Museum of Athens), and Bryaxis. The Roman sculptors, as well, liked to create her image. Good examples of the Roman works of Hygieia are located in the museums' collections in Epidaurus, Herakleion, Nicosia and Rome. The late ancient ivory-cut relief from Walker's gallery in Liverpool is representing Hygieia in her typical form as a fine young woman feeding a huge sacred snake which is wrapped around her body. We learn from Pausanias about a special kind of big -- but not venomenal -- snake living in the region of Epidaurus. Sometimes Hygieia is accompanied by Telesforos, the dwarf with a cowl on his head, who is a symbol of the recovery. According to some myths he was the brother of Hygieia and a deity in Thrace.
With the increasing importance of Asklepios' cult during the Roman period, Hygieia was associated with the moon and her father, the most worshipped of the gods, and was considered as the equal of the sun. The name of Hygieia survives in present times in words such as hygiene. Her sacred snake together with the rod of Asklepios is the symbol for medicine.