Last updated October 28, 2026
You’ll run the numbers on everything else, so run them on the house. This is the St. Louis real estate side of the decision, from 2026 closed sales: whether buying beats renting for the years you’ll be here, where people live near each major hospital, what your budget actually reaches, and what a home costs to hold. The financial plan around it belongs with your advisor, and the last section gives you the questions to bring.
Rent if you’ll be here less than about three years; buy if you expect to stay longer on a stable contract. Buying and later selling a St. Louis house costs roughly 10% to 14% of the price, and from 2021 to 2025, St. Louis County prices rose about 5% a year per square foot, so it took about two to three years of appreciation just to cover the round trip. The round-trip math ↓
Near WashU Medicine and Barnes-Jewish in the Central West End and SLU Hospital in Midtown: Clayton, University City, Webster Groves, Kirkwood and South City neighborhoods. Near Mercy in Creve Coeur and Missouri Baptist in Town and Country: Creve Coeur, Ladue, Frontenac, Town and Country, Des Peres and Kirkwood. Near St. Luke’s in Chesterfield: Chesterfield, Wildwood and Ballwin. Areas by hospital ↓
A lot in some cities and almost nothing in others. In 2026 sales, $750,000 or less covered 84% of Webster Groves sales, 69% in Kirkwood, 68% in Creve Coeur, 63% in Chesterfield, 19% in Town and Country and 7% in Ladue. Every city, side by side ↓
They let doctors buy with little or nothing down and no private mortgage insurance, often qualifying on a signed employment contract and treating student loans more favorably than a conventional loan. Down payment tiers, loan limits, rates and student-loan rules vary by lender, so compare at least two. What to compare ↓
Treat it as a place to live that can also build equity, not as your best investment. Holding it costs about 0.8% to 1.1% of the price a year in property taxes alone near the hospitals, plus insurance and repairs, and older houses need more. The money questions belong with your financial advisor. The home-as-an-asset math ↓
Sources: 2026 MLS closed single-family sales inside each city; St. Louis County residential sales, 2021 to 2026; physician loan terms from lender materials. Real estate information only, not investment, tax or legal advice.
Start with how long you’ll stay. Buying and later selling a St. Louis house costs roughly 10% to 14% of the price, so the house has to appreciate enough to cover that before buying beats renting on resale alone.
| Cost | Share of price | On a $750,000 house |
|---|---|---|
| Buying: closing costs | 2% to 3% | $15,000 to $22,500 |
| Selling: commission, title, taxes, concessions, prep | 8% to 11% | $60,000 to $82,500 |
| Round trip | 10% to 14% | $75,000 to $105,000 |
From 2021 to 2025, St. Louis County’s typical price per square foot rose from about $169 to $205, roughly 5% a year. At that pace, appreciation covered a 10% to 14% round trip in about two to three years. That’s history, not a promise, and it’s before mortgage interest, taxes and upkeep are weighed against rent.
Run the buy-vs-rent math for your income and stay → · When buying beats renting in St. Louis → · The full cost to sell →
The five major hospitals sit in two clusters. WashU Medicine, Barnes-Jewish and SLU are in the city’s central corridor; Mercy, Missouri Baptist and St. Luke’s are out along I-270 and I-64 in West County. Where you’ll work narrows the map fast.
| Hospital | Where it is | Areas nearby |
|---|---|---|
| WashU Medicine and Barnes-Jewish | Central West End | Central West End, Clayton, University City, Dogtown, St. Louis Hills, Webster Groves |
| SLU Hospital | Midtown, near Grand Boulevard | Shaw, Tower Grove South, Central West End, Maplewood, Webster Groves |
| Mercy Hospital St. Louis | Creve Coeur, on New Ballas Road | Creve Coeur, Ladue, Frontenac, Town and Country, Des Peres, Kirkwood |
| Missouri Baptist Medical Center | Town and Country, on Ballas Road | Town and Country, Des Peres, Frontenac, Kirkwood, Ballwin |
| St. Luke’s Hospital | Chesterfield | Chesterfield, Wildwood, Ballwin, Town and Country |
Check the drive at the hours you’ll actually make it, especially for early or overnight shifts. West County cities compared →
It depends far more on the city than the number. Here’s what 2026 sales inside each city looked like, with the median annual property tax and how much of each market a $750,000 or $1,000,000 budget reached.
| City | Median price | Median yearly tax | $750K or less | $1M or less |
|---|---|---|---|---|
| Webster Groves | $444,500 | $4,816 | 84% of 82 | 91% of 82 |
| University City | $439,200 | $4,987 | ||
| Ballwin | $419,950 | $4,443 | 99% of 86 | 100% of 86 |
| Kirkwood | $566,750 | $4,995 | 69% of 80 | 83% of 80 |
| Wildwood | $599,000 | $6,522 | 67% of 136 | 86% of 136 |
| Creve Coeur | $640,000 | $6,685 | 68% of 59 | 81% of 59 |
| Chesterfield | $685,000 | $6,639 | 63% of 120 | 83% of 120 |
| Des Peres | $925,000 | $6,310 | 44% of 25 | 56% of 25 |
| Clayton | $1,240,000 | $11,638 | ||
| Frontenac | $1,325,000 | $10,898 | 2 of 11 | 5 of 11 |
| Town and Country | $1,348,000 | $9,308 | 19% of 31 | 35% of 31 |
| Ladue | $1,430,000 | $13,692 | 7% of 27 | 11% of 27 |
Two patterns stand out. Clayton, Ladue, Frontenac and Town and Country start around $1.24 million to $1.43 million at the median, so a $1 million budget reaches only a sliver of them. Webster Groves, Kirkwood, Creve Coeur and Chesterfield put most of their market within $750,000 to $1 million. University City and Clayton budget shares aren’t shown because those pages report different price breaks. Town and Country, Frontenac and Ladue compared → · Kirkwood vs. Webster Groves → · Chesterfield vs. Wildwood →
They change the cash you need, not the price of the house. Most programs share four features, but the details vary by lender:
Low down payment doesn’t mean low cash: closing costs still run 2% to 3%, and a small down payment means a bigger loan and less equity if you sell early. Compare at least two lenders on the rate, the down-payment tier for your price and exactly how your student loans are counted. What St. Louis closing costs include →
The contract feature only helps employed doctors. If you own your practice, are buying into a partnership or work locums on a 1099, the lender reads your last two tax returns instead, and every write-off lowers the income it counts. How practice owners and partners qualify →
More than the mortgage. Near the hospitals, the median property tax ran about 0.8% to 1.1% of the sale price in 2026, from about $4,400 a year in Ballwin to $13,700 in Ladue. Add insurance, and budget for upkeep, because much of this housing is older: 66% of Kirkwood’s 2026 sales and 89% of Webster Groves’ were built before 1960.
| Year | Typical monthly median | Change |
|---|---|---|
| 2021 | $168.50 | |
| 2022 | $175.50 | +4.2% |
| 2023 | $179.50 | +2.3% |
| 2024 | $194.00 | +8.1% |
| 2025 | $205.00 | +5.7% |
| 2026 (January to September) | $219.00 | Partial year |
Price per square foot rose every year from 2021 to 2025, but unevenly: 2.3% one year, 8.1% another. Prices also swing within each year, peaking on June and July closings. A home you’ll live in for years can build real equity; a home you need to sell on a deadline is a bet on timing. Five years of St. Louis seasonal data → · The repairs that wreck budgets →
Sometimes, but run the rental math before you count on it. From 2023 to 2025 I sold 130 homes for an investor team, and whether a house works as a rental comes down to the same test every time: the rent, minus taxes, insurance, repairs, vacancy and management, measured against what you paid.
A house bought as a family home near the hospitals, at those prices and tax bills, has a high bar to clear. If keeping it as a rental is part of your plan, price that rent before you buy, not when you’re relocating. How investors price a house →
Bring the house numbers to the person who sees the rest of your finances. Six questions to start with:
This page covers the real estate side only. It isn’t investment, tax or legal advice; your advisor and lender should run your own numbers.
Residency, loans and contracts
Only if you’ll stay long enough. Buying and later selling costs roughly 10% to 14% of the price, so a residency of four years or more in a house that resells easily is where buying can work. For a shorter program, renting usually wins. A physician loan can qualify you on your contract with little down. Buy or rent by timeline ↑
It’s worth it when keeping cash invested or in reserve matters more than the slightly higher rate some lenders charge. Little or no down payment and no private mortgage insurance let you buy sooner, but a small down payment means a bigger loan and less equity if you sell in the first few years. What to compare between lenders ↑
A conventional loan with less than 20% down requires private mortgage insurance and counts student loans under standard rules. A physician loan usually skips mortgage insurance with 0% to 10% down, can qualify you on a signed employment contract and treats student loans more flexibly, sometimes at a slightly higher rate. Physician loan features ↑
Often, yes. Many physician loan programs qualify you on a signed contract for a job that starts within about 60 to 90 days of closing. Lenders verify the salary and start date, and a delayed start can affect the approval. How physician loans qualify you ↑
Where to live
Close in: the Central West End, Clayton, University City, Dogtown and Webster Groves. In 2026 sales, the median was $439,200 in University City, $444,500 in Webster Groves and $1,240,000 in Clayton. Areas near each hospital ↑
For Mercy in Creve Coeur: Creve Coeur, Kirkwood, Ladue, Frontenac, Town and Country and Des Peres. For St. Luke’s in Chesterfield: Chesterfield, Wildwood and Ballwin. 2026 medians ran from $419,950 in Ballwin and $685,000 in Chesterfield to $1,430,000 in Ladue. Prices and taxes by city ↑
In 2026 sales, the median annual property tax ranged from about $4,400 in Ballwin and $4,800 to $5,000 in Webster Groves, Kirkwood and University City to $9,300 in Town and Country, $11,600 in Clayton and $13,700 in Ladue, about 0.8% to 1.1% of the sale price. Taxes by city ↑
This is one piece of the St. Louis home buying process. See how it all fits together:
📚 Complete St. Louis Buyer Guide →
Grew up in South St. Louis, lived in Dogtown for 6 years, now in South County. You'll find us at Wellspring on Lindbergh on Sundays. I'm not selling you a house — I'm showing you how to think about buying or selling a house.
Questions about what you are reading? I answer personally — no team, no handoff.