Fletcher was the daughter of farmer Andrew Jackson Bray and seamstress Mary Frances Bray of Georgia. She attended Lucy Craft Lacey's Haines Institute in Augusta, Georgia; Hampton Institute in Hampton, Virginia; and Alabama A&M College in Madison County, graduating in 1904. Afterward she served as chief nurse at Sterr's Hospital in Decatur. She was briefly married to Edward David Morrison.
Fletcher came to Birmingham in 1906 to take charge of the Children's Home for Negroes Hospital. In 1909 she was employed by United Charities of Birmingham, a forerunner of the Jefferson County Department of Health as a nurse and social worker. She married Andrew Jackson Fletcher in 1912, but was widowed in 1915. That year she was hired as a field nurse for the American Cast Iron Pipe Company and in [ she began working for the Jefferson County Anti-Tuberculosis Association under Bertha Clement.
The Anti-Tuberculosis Association operated a Kiddie Camp on Shades Mountain for white children suffering from the tuberculosis, and Fletcher saw the need for a similar facility for African Americans. She visited Camp Elwema in New York while traveling for a meeting of the Graduate Nurses Association and prepared a report on her findings. She organized the Girl's Service League to raise donations to purchase property for a convalescent camp for African American women and children, which she named in honor of Margaret Murray Washington, the wife of Booker T. Washington. A year later she mortgaged her own home to finance the construction of a 5-room cabin.
In recognition of her many sacrifices on behalf of the public, the board of the Girl's Service League voted in 1942 to rename the camp in Fletcher's honor. Camp Fletcher has since been expanded to more than 300 acres and has been used as a recreational camp by the Youth Service League (successor to the Girl's Service League]], and later by Camp Fire USA.
Through the efforts of businessman A. G. Gaston, a monument to Pauline Fletcher was erected at Kelly Ingram Park in downtown Birmingham in 1979. A documentary film, The Legacy of Pauline Bray Fletcher was produced in 2015.
- Watts, Carrie E. (August 1, 1948) "History and development of Camp Pauline Bray Fletcher, Bessemer, Alabama, with emphasis on the 1947 program" Master's Thesis, Atlanta University School of Social Work. ETD Collection for AUC Robert W. Woodruff Library. Paper 704.
- Fletcher-Tuggle Memorial Committee Inc. (1970) "Cultural heritage journal of the Fletcher-Tuggle Memorial Committee, Inc." booklet - via Birmingham Public Library Digital Collections
- Moore, Geraldine (October 2, 1979) "Monuments honoring black women unveiled in ceremony" The Birmingham News - via Birmingham Public Library Digital Collections
- Wilson, Hayley (April 20, 2022) "Meet Pauline Braye Fletcher, Camp Founder, First Black Registered Nurse in Alabama." The Birmingham Times