How did cities manage the health of their residents starting in the 19th century? Faouzia Perrin presents a historical overview of the measures gradually put in place: hospitals placed under municipal jurisdiction in the late 19th century, the creation of public health departments (covering social medicine as well as urban sanitation), and tuberculosis clinics. Throughout the 20th century, cities gradually assumed a predominant role in the healthcare system. Beginning in 1983, municipal health and sanitation departments often consolidated these functions. The 2009 “Hospitals, Patients, Health, and Territories” Act is expected to strengthen collaboration between the state and cities by establishing local health contracts.