In 1902 the Ottoman government in Damascus undertook a project of bringing fresh water from the Fijah Spring in Damascus’ suburb to the city. Until then, Damascus relied on the historical river Barada for the city’s water consumption and the irrigation of its gardens. This project was in line with the recommendations of the germ theory and was meant to supply Damascus with fresh uncontaminated water to combat water-borne diseases. However, this measure did not bring the results that the government aspired for. Cholera continued to cause death in the city as late as 1917 of the Ottoman rule. Despite the government’s instructions of abandoning Barada, bringing Fijah water to Damascus did not automatically cancel other routine usages of Barada such as washing fruits, vegetables and bodies. Use of Barada continued. That water can cause health problems was not a new piece of knowledge for Damascenes. Already before the germ theory, Damascenes associated water abundance with certain fevers with which they had long learned to live. However, since the emergence of the germ theory, they had to accept that their river was not only a source of life but also a source of death, and despite its accessibility and availability they were instructed to abandon using it. This new reality together with the limited availability of Fijah water in the early stages of the project made people ignore and sometime resist the Ottoman government’s instructions and measures. In the face of disease persistence, a new discourse of Islamic hygiene started circulating in medical journals, newspapers, and in mosques. Both government officials and doctors mobilized Islam as possibly the most efficient way to ensure permeability of state’s instructions in all classes in and outside the city. Islam and hygiene were paired as compatible systems of controlling the body’s cleanliness and health. This paper explores public health and urban space in the late Ottoman Empire Syria and investigates how public health interventions intersected with ideas of class and religion to impose on them material and normative meaning. Ottoman efforts to protect the society from various diseases unleashed the rapid change urban spaces and the rise of modern Damascus.