In September 2007, Counties Manukau District Health Board, ARTNL and ARTA opened a new railway footbridge and staff walkway at the station. The footbridge provides safer access to Middlemore Hospital from the staff carpark.
In 2023, KiwiRail commenced an upgrade at Middlemore station. The station upgrade will include building a new third platform to service the third main line. The new platform will be located on an island platform. The island platform is an extension of the current platform 1. The upgrade is expected to be completed in 2025.[4][5]