The current conflict in Iraq represents a compelling example of a “man-made disaster.” This paper highlights the systemic health and social consequences of the US invasion of Iraq, illustrating how the current conflict represents a continuation of structural violence against Iraqis initiated in the 1990s via economic sanctions following the first “Gulf War.” The humanitarian crisis in Iraq must thus be understood as a long-term process, including the impact of the 1991 Gulf War and more than a decade of UN economic sanctions and a separate US trade embargo. These events had a cumulative negative impact on Iraqi society, effectively dismantling its public health system and undermining the welfare of most Iraqis. The 2003 U.S. invasion and ongoing occupation of Iraq have further destabilized Iraqi society and key public institutions. As a result the well-being of most Iraqis remains fragile. Yet while violence remains widespread in Iraq, it accounts for only one aspect of the nation’s public health crisis. The current conflict, fueled by US neo-liberal policies, has led to the “sectarianization” of public services, including health care, and a failure to prioritize inclusive social development. Preventable disease, child/infant mortality, and “excess” deaths have increased throughout Iraq. Malnutrition, lack of sanitation, clean water, and access to basic medical services contribute to these trends. Of particular concern is the long-term mental health impact of pervasive violence and instability, especially on Iraqi children, an issue that has been largely ignored in scholarship and media coverage of Iraq. Conflict in Iraq has also accelerated the dismantling of the medical system, as health care professionals have become the deliberate targets of insurgent groups as a “weapon of war.” With health providers increasingly at risk, Iraq has experienced a “brain drain” of the most qualified medical personnel, including the loss of educators training new health professionals. While overt violence subsided in 2008, the ramifications of massive human displacement, high rates of unemployment and underemployment, and the degradation of public health infrastructure will reverberate in Iraq for years to come. As the U.S. government reduces its formal presence in Iraq, international organizations and other countries must continue to help strengthen civil society in Iraq in an effort to promote social development. This paper is based on documentary research and interviews with more than 60 informants working in humanitarian and human rights NGOs and UN agencies.