Hannah Battatu described Ottoman Iraq as, “…a death trap, a ‘devourer’ of people,” with numerous endemic scourges, administrative neglect, floods, drought and war devastating its inhabitants. This region of the Ottoman Empire received the attention and support of Istanbul only when disease and environmental crises threatened the state’s authority or seriously hindered productivity. Istanbul dispatched a limited number of doctors who worked in an underserviced environment. The conditions in Iraq made such positions undesirable to an increasingly elite professional cadre with cosmopolitan appetites. As such, medical pluralism characterized public health, and health care and labour in Ottoman Iraq. This paper offers an examination of medicine in Ottoman Iraq from the late nineteenth century, when Istanbul worked to institutionalize the medical profession, until the British occupation of 1917. The following examination positions Iraq in present debates regarding public health legislation, medical professionalization, and the persistence of homeopathy in the late nineteenth and early twentieth centuries. Specifically, Ottoman Iraq hosted an amalgam of state-assigned officials including doctors from within the realm, contracted foreign labour, as well as non-accredited medical specialists. This amalgam reflected the plural medical apparatus that serviced Ottoman Iraq. The harmonization of Greco-Islamic medical thought along with emerging contentions of germ theories introduced in regional medical schools yielded a medical pluralism that facilitated room for both university accredited as well as apprenticeship trained medical labour at a time when what constituted public health and scientific medicine underwent significant legislative and cultural transformations.