Born 7 February 1861, the eldest son of the Hon William Napier of MacMac, Lydenburg, South Africa, and his wife Louisa Mary, youngest daughter of John Horatio Lloyd, QC. His grandfather was William, 9th Lord Napier and Ettrick. He was educated at St Bartholomew's Hospital, London, where he served as house surgeon and ophthalmic house surgeon, and was clinical assistant at the Royal London Ophthalmic Hospital, Moorfields. He went back to South Africa for a time as ophthalmic surgeon to the New Somerset Hospital. In 1893 he settled in Glasgow on appointment as ophthalmic surgeon to the Royal Infirmary and professor of ophthalmology at St Mungo's College; he was also surgeon to the Ophthalmic Institution. He returned to South Africa as a civil surgeon with the British Army during the Boer War, and won the Queen's and the King's medals. He is mentioned by name in Sir Winston Churchill's memoirs of the siege of Ladysmith, in connexion with the armoured train disaster at Chieveley. In the first world war he served as a major with the South African Medical Corps, was mentioned in despatches and created a military OBE. Napier practised as an ophthalmologist at Johannesburg for fifty years, and was consulting surgeon at the General Hospital, where the Napier Eye Department was named after him. He was president of the Medical Association of South Africa in 1931. The British Medical Association later presented him with a presidential medal, through the hands of Sir Hugh Lett, FRCS. Napier took an active share in public affairs, serving in the Johannesburg City Council and the Transvaal Legislative Assembly. He was made an honorary Doctor of Law by the University of the Witwatersrand. He married twice: (1) in 1893 Margaret, daughter of Lieutenant-Colonel William Hope, VC, from whom he obtained a divorce; two of their three sons survived him; (2) in 1923 Isoline Richards Shotter, who survived him. Napier died in Johannesburg on 8 October 1949, and his ashes were sent home to Scotland. They were buried in Ettrick churchyard by Lord Napier and Ettrick on 18 January 1950.