Adopting Foucauldian ideas of medicalization, this article asks how far poverty was a significant site of medical knowledge and public health expertise in nineteenth- and early twentieth-century India. Although conspicuous, poverty was seen as only one of many ‘predisposing’ causes of disease or as the consequence of disease rather than its cause. Environmental and cultural factors were assigned greater prominence in explaining epidemics, while Malthusian ideas served to explain the perceived inevitability of disease in the face of ‘overpopulation’. The rise of bacteriology, parasitology and medical entomology further directed expertise away from the centrality of poverty. Only by the nineteen-thirties, as poverty became a matter of wide public debate and nutritional science provided a new point of entry into its understanding, did poverty come to be closely identified with ill-health and its amelioration.