The gradual progress of health care within Namibia (formerly known as German South-West Africa), coincided with the three major historic periods: colonial settlement, the Herero-Nama genocide (1904-1907), and the transition of administration of the colony after the First World War. Here the authors draw upon primary and secondary sources to provide insights on the development of hospitals, health care and racial hygiene in in the colony with specific reference to Windhoek. The aim here is to contribute towards the lacking historiography of the medical landscape of Windhoek. Health care during the period of German colonial rule was centralised and segregated, and this trend prevailed when South Africa undertook administration of the colony. The initial strategy under German rule was to increase the formal treatment facilities within Swakopmund and Windhoek during the 1890s. The early growth of health care and hospitals was chiefly aimed at the needs of the white Europeans and driven by principles of racial hygiene.