Existing histories of public health in Iran tend to focus on elite or urban narratives. Rural populations often appear in these narratives as national or provincial statistics, without the close look enjoyed by Tehranis or heads of state. This paper shifts the focus to Iran’s villages by examining the modern public health history of Khuzestan (southwest Iran), especially after rural services began to expand in 1958. Although plans for modern medical services in Iran date back to at least the early 19th century, no broad program for addressing rural public health in Khuzestan surfaced until the late 1950s. Even then, the primary goal of the health program was not to alleviate rural morbidity and raise the standard of living for the sake of villagers themselves. I argue that Khuzestani villagers desired modern medical services but the state health program’s roots in national economic goals (rather than social well-being) and detached, top-down decision-making led to the uneven distribution of services and the violation of personal agency. Khuzestan’s rural populations only gained access to health care after the Pahlavi government viewed them as potentially economically beneficial, and the public health program it instituted prioritized societal control over community wellness. As a result, health program results were uneven: village agents forced thousands of residents to undergo mass chemotherapy treatments to prevent water-borne parasites while other Khuzestanis were unable to access clinics built within their own communities. Born from a systemic imperative to control the masses and increase national prestige, government agents attempted to impose a vision of an orderly and hygienic society in Khuzestan divorced from residents’ actual needs and desires. This aspect of state intrusion into village life has been overlooked as historians of modern rural Iran often focused on the land tenure effects of the White Revolution initiatives begun in 1963. The Plan Organization of Iran partnered with the Development and Resources Corporation (United States) to institute these programs before Iranian ministries assumed primary responsibility for them in the mid-1960s. This paper uses DRC archival records and village studies conducted by Iran’s Ministry of Education and Tehran University to bring a richer picture of Iran’s villages into historical focus while also contributing to the small but growing literature on the environmental history of Iran.