Whilst much work has been done to highlight the plight of the urban poor in less developed countries, little information exists about differences in health between poor urban areas. This paper describes environmental and other health hazards in five slum settlements in Visakhapatnam, India. Despite considerable differences in infrastructural and socio-economic development, morbidity rates were not found to vary between the study settlements. Methodological and epidemiological explanations for this lack of variation are discussed.