The project is a contemporary history of medical garbage in Chennai. On the one hand, the history of medical garbage (‘biotrash’) is a history of the lives and livelihoods that cluster around the illegal recovery of discarded medical items. On the other hand, the history of biotrash is a history of the laws, institutions and bureaucrats who together have comprised the repeated official, failed attempts to eradicate this informal economy from the city’s landscape. By ‘medical garbage,’ I refer to manufactured objects routinely used and discarded in clinical encounters (e.g., used disposable syringes, medical tubing, blood bags, pharmaceuticals and pharmaceutical containers). This project examines medical garbage during a recent—and largely celebrated—chapter of Indian history which has seen significant economic growth alongside new policies of market liberalisation. By investigating the corollary histories of and contact zones that connect the informal market for biotrash and the official policies that address it, this project illuminates the sinews that connect India’s recent success to its constitutive underside.