An outbreak of cholera in Egypt in 1883 presented the newly installed Anglo-Egyptian government with its first major crisis. The government’s response marked a break from established public health policies and procedures away from those that developed by the Ottoman Egypt government with French assistance in the early and mid nineteenth century, and implemented anti-contagionist policies developed in British India two decades earlier that considered cost and economic impact key factors. The British empire and its representatives in Egypt had strong opinions about what constituted "modern" medical practice, the appropriate relationship between medical provider and consumer, and the ways in which the consumer was expected to behave; personal hygiene practices and the acceptance of medical care were seen as markers of modernity and progress, even when restricting access to health services came at the expense of over fifty thousand Egyptian lives. In this paper, I describe how the 1883 outbreak provided the nascent Anglo-Egyptian administration with the ability to remake the Egyptian health service along measures both more in fitting with imperial attitudes and desires for fiscal austerity. As a result, health, hygiene, and sanitation practices of ordinary Egyptians became used as litmus tests to justify indefinite extension of the British occupation.