Existing histories of public health in Iran often center on elite or urban narratives. This paper shifts the focus to Iran’s villages by examining the twentieth century public health history of rural northern Khuzestan. It argues that Khuzestani villagers desired, rather than resisted, modern medical services. However, vertical decision-making and the prioritization given by public health planners to economic concerns over social well-being led to the uneven distribution of services and failure to fulfill the expectations of Khuzestan’s villagers. This paper uses memoirs, official reports, correspondence, and other records from the Development & Resources Corporation, along with reports from Iran’s Ministry of Education and Ministry of Health, to bring a richer picture of Iranian villagers’ twentieth century history into focus.