The Greek historian Herodotus called Egypt the “gift of the Nile,” an acknowledgement of how everything in the Nile Valley, including life itself, depends on the river. Yet today the Nile is not as dependable as it once was. Much attention has been paid to the increased scarcity of the Nile waters in Egypt, especially amid the construction and filling of the Grand Ethiopian Renaissance Dam, which Egypt has opposed. As Egypt’s population continues to grow, many worry that its share of the Nile waters will soon be insufficient to meet the needs of its residents. Scholars have also explored the consequences of colonial and postcolonial interventions in the Nile, including the rapid spread of dangerous parasitical and bacterial infections. However, the polluting of the Nile, which has powerfully contributed to rendering the river a source of widespread illness and death in addition to life, has been less examined, especially among social scientists. Since the acceleration of industrialization in Egypt in the 1950s, the Nile waters have increasingly absorbed a range of contaminants from industry, agricultural runoff, domestic sewage, and other sources. As the toxicity of the water has increased, so too has its health toll on Egyptians. In Egypt, polluted water has contributed to inordinately high rates of cancer, renal disease and renal failure, and other conditions, profoundly reshaping lives and communities, not least through disability and death. Drawing on governmental and nongovernmental reports, periodicals, and personal accounts, this paper analyzes the polluting of the Nile during Egypt’s postcolonial period, from the era of nationalization to that of neoliberal authoritarian development. In tandem, it traces the rise of a type of “politics of care”—which centers the basic needs of humans, in addition to the natural world—in response. This politics, a product of contemporary conditions and crises at both the local and global levels, has manifested in groups of Egyptians seeking dignity together amid at once the receding of the state and its intimate involvement in the lives of its citizens through the contamination of bodies and the natural world, as one piece of a broader patchwork framework of development. In analyzing pollution and politics in Egypt, this paper seeks to connect scholarship on development, disability, the environment, postcolonial citizenship, and the postcolonial state.