According to the hospital's administrator, a new location for the hospital would better serve the community for the ensuing 50 years.
Maintenance on Reading's Royal Berkshire Hospital building will cost £200 million.
Construction on the first hospital building began in 1839. The hospital has some wards that are more than 175 years old.
The White Waltham Airfield and Newbury Showground are two off-site developments that the Royal Berkshire NHS Foundation Trust has been considering.
It is one of 48 trusts that will get funding from the government to renovate or build new hospitals by 2030.
Previously, Reading Borough Council expressed concern that some residents might not be able to get to the potential new sites.
The Royal Berkshire NHS Foundation Trust's chief executive, Steve McManus, stated: "We've got physical estate that clearly requires levels of maintenance that, in more contemporary buildings, we know that money would be better applied because of the physical environment. ".
He claimed that the best opportunity to put some of that investment to use would be to build a brand-new hospital on a new location.
To actually build a hospital that would endure for the ensuing 50 years and beyond, rather than just 10 or 20.
It happens in a year when NHS employees have been engaging in industrial action over pay disputes and as the NHS marks its 75th anniversary.
The historic anniversary has also been greeted by warnings that, absent significant change, it is unlikely to last until its 100th birthday.
The King's Fund, the Health Foundation, and the Nuffield Trust are three think tanks that have urged political leaders to adopt a fresh strategy.
The Kings Fund's chief analyst, Siva Anandaciva, stated: "History shows us that we do need to spend more money on the NHS.
"Anything less than 2 percent is managed decline, and the 3 to 4 percent we are currently spending is just stagnant.