was born on April 11, 1862, to Caroline Noyes and Henry Butler in Fayetteville, North Carolina. Between 1872 and 1874 his family moved to Wilmington, in the southern portion of the state. He had one known brother, Philip. Like many African Americans living in rural environments during the late nineteenth century, Butler spent his youth on a farm, where he received no formal education. As he grew older, he helped to support the family through work in local hotels and lumber mills.
Georgia, played a pivotal role in Butler’s education. In the evenings after work, Green and his wife tutored Butler in preparation for college. The effort proved a success, and in 1883 Butler entered Lincoln University in Pennsylvania. After graduating four years later, he continued his education at Meharry Medical College in Nashville, Tennessee, where he graduated with a medical degree in 1890.
As Jim Crow took hold of the region, Butler and his Meharry classmate Thomas Heathe Slater established a medical practice and drugstore for black residents on Wheat Street (later Auburn Avenue) in 1891. The two obtained the first pharmacy license in Georgia to be granted to African Americans. Butler and Slater purchased a store owned by J. C. Huss, a white druggist who trained Moses Amos, the first licensed African American pharmacist in Georgia. After two decades in business, Butler Slater and Company changed ownership when Amos bought the drugstore, reopening it in 1914 in the Odd Fellows building near the corner of Butler Street (later Jesse Hill Jr. Drive) and Auburn Avenue. Butler’s medical practice, however, spanned forty years. Later in his career, around 1912, Butler furthered his studies in gynecology, obstetrics, and pediatrics at Harvard University Medical School.