The building was designed by architect Harrison Albright, who built the theater in the baroque style, with numerous allegorical paintings and a large painted mural above the stage. The Grand Lobby's walls, ceilings, and stairs are faced in Predora onyx and the original stained glass window above the theater entrance was created by Tiffany Studios.
Over the years, the Spreckels has hosted some of the city's finest performances. It was built to host live theatrical performances, and in its early years the theater functioned primarily as a vaudeville house. With the growing popularity of motion pictures, however, the theater was modified in 1931 to allow for movie screenings. In the ensuing years, the Spreckels has hosted theatrical productions, first run films, touring acts, and comics. The theater has operated almost continuously over the last century, with only brief interruptions for renovations.