In the nineteenth century legislation concerning health care in Greece did not differ from that in the Netherlands, derived as it was from the French example in both cases. This article contains a comparison of the organisation and the effects of (public) health care in the Dutch city of Groningen and the Greek city of Piraeus, cities which in the course of the nineteenth century reached about the same size. It shows that on the local level, in spite of the convergence in national legislation, there were large differences in the way (public) health care was distributed and in the acceptation by the public. This was for example reflected in different death ratios.