Hospitals have for centuries been considered safe havens for immigrants and people on the move. However, immigrants and migrants who seek health care have also been targeted for exclusion and deportation. This article discusses the history of how hospitals and health care facilities in the United States have acted both as sanctuaries and as sites of immigration enforcement. This debate came to a head in California in the 1970s, when conservatives began attacking local public health facilities’ informal sanctuary practices. Following the California battles, which culminated in Proposition 187 in 1994, immigrant rights movements have increasingly connected calls for sanctuary with demands for a right to health care.