The objective of this study was to primarily get an overview of the availability health services and disease patterns in Hyderabad. Some broad picture has emerged as an outcome of this study but it needs to be again mentioned that this is only an incomplete picture as a lot of health data is not represented in this study due to non-availability. A major observation of this study is that data on health in Hyderabad is sketchy and no complete data bank on health is available. Nonetheless, the major outcomes of the study indicate some important trends that need to be highlighted and considered for further research. 1. Distribution of health services in the city is not uniform. Private health care is more used and spread over the city, outnumbering government health facilities. But in poorer areas, outskirts, and parts of the Old City, private health facilities are fewer. It is in these areas that government health care needs to address the health needs of the people with more facilities. This is not to say that government health facilities in other areas need to be ignored. Circles 1, 11, and 111 have fewer health facilities than other Circles. 2. While the poor do see government health care as their first choice, they are forced to shift to the private health sector due to lack of doctors, proper treatment and proximity. There is therefore an urgent need for strengthening and improving services in government health sector. 3. The disease profile shows a resurgence of infectious and communicable diseases in the city. TB, Diphtheria, Malaria are major causes of morbidity. The rise of Chikungunya in 2006 further emphasizes that most of these diseases are preventable. The very high numbers of diarrhea and enteric fever cases, specially among children clearly points to the poor public health facilities in slum colonies. 4. Women in the slums are in poor health with high numbers reporting anemia linked problems, RTI and UTI. STD cases also appear quite high in Salivahana Nagar. As the treatment for these diseases is long drawn and involves the spouse/partner, the urban health post needs to include men also in treatment for it to be effective. 5. Data from both the UHP shows that family planning by pushing contraception seems to be a major agenda, besides immunization. In conclusion, this study argues that health care has to be a state concern with the state being the major provider. The private health sector can only be an option, not the main health care provider. In a situation, where economic inequality is sharp and wide with 30% of Hyderabad’s population in slums, State responsibility in public health and primary health care provision is absolutely critical. Moreover, the comeback of old and emergence of new diseases in the city in recent years, supports this demand for greater government role. New diseases like Chikungunya make no class, caste, area, gender distinction thereby suggesting that a collapse of public health and poor environment can lead to both old and new epidemics. This study claims to only unravel the tip of the iceberg and the signals it sends are disturbing and need urgent attention by health planners. (Acknowledgements: The authors would like to thank Ms. E. Deepa who assisted in data collection and analysis for the study)