The island was subsequently used as a leper colony from 1903 to 1957. The last inhabitant, a priest, did not leave the island till 1962, in order to maintain the Greek Orthodox tradition of commemorating a buried person 40 days, 6 months, 1 year, 3 years, and 5 years after their death. Spinalonga was one of the last active leper colonies in Europe; others that have survived Spinalonga include Tichileşti in Eastern Romania, Fontilles in Spain and Talsi in Latvia. As of 2002, few lazarettos remain in Europe.
There were two entrances to Spinalonga, one being the lepers' entrance, a tunnel known as "Dante's Gate". This was so named because the patients did not know what was going to happen to them once they arrived. However, once on the island they received food, water, medical attention and social security payments. Previously, such amenities had been unavailable to Crete's leprosy patients, as they mostly lived in the area's caves, away from civilization.
Today, the uninhabited island is a popular tourist attraction in Crete. In addition to the abandoned leper colony and the fortress, Spinalonga is known for its small pebble beaches and shallow waters. The island can easily be accessed from Plaka, Elounda and Agios Nikolaos.
Spinalonga is under consideration to become a World Heritage Site.