As Erin O’Connor recently noted, "Asiatic cholera exposed the frailties of England’s urban industrial structure," and it provided the most serious test of the old Poor Law system in Birmingham. This paper intends to explore the response of the medical, political, and religious authorities of Birmingham to the outbreak of cholera in 1832 as well as the popular reaction to this response. It also seeks to explain why, in Asa Briggs’ words, "Birmingham was almost untouched . . . in the cholera outbreak of 1832 (when there were only twenty-one deaths)" by analyzing the geography, social and political structures of the town, and the medical and moral pathology of the disease. By using the minutes of the Birmingham overseers and guardians of the poor, together with contemporary newspaper reports, the paper seeks to uncover the dramatic and entirely unexpected course of events in Birmingham. It offers an analysis of the city’s response to the disease that challenges interpretations of the unreformed Poor Law as passive and unsympathetic and the unincorporated local authorities as chaotic and corrupt. The episode also sheds light on competing cultural attitudes toward death and disease among the communities that made up early nineteenth-century Birmingham. The only areas where the authorities’ actions were significantly interfered with were those where the poorest (including the Irish) lived. Here, swift removal of corpses clashed with traditional funeral practices and the widespread fear of "burking" by anatomists provoked serious disturbances. The paper concludes that Birmingham was spared the pandemic by the happy combination of location (far from the sea in the pre-railway age), infrastructure (with deep artesian wells supplying most drinking water, in contrast to the reliance on streams and rivers elsewhere in Britain) and the uniquely well-organized response to the epidemic by the overseers and guardians of the poor, the town’s medical practitioners, and the Board of Health, chaired by Samuel Galton. The paper concludes that it was to the country’s detriment that the city’s effective response to the disease was largely overlooked at the time and that it took until 1854 when Jon Snow was able to compare those drinking contaminated and uncontaminated water and draw the conclusions that led to the provision of an effective response to the problem of cholera in the cities of Britain.