This paper examines the malaria prevention program organized by Dr. Ronald Ross from 1902-3 in Ismailia, and later in Port Sa‘id. I also investigate the ecological transformations that were disciplined and moved to make way for the two new cities and two new canals (Fresh Water Canal and Suez Canal). Water, sand, plants, animals and insects were fought against in a variety of ways to make way for the canal projects. Ross made his name in British colonial India where he found that a species of Anopheles mosquito transmitted malaria to birds. He would join the Liverpool School of Tropical Medicine in 1899 and from there was invited by the President of the Suez Canal in 1902 to examine the causes of malarial fever in Ismailia and Port Sa‘id. Ismailia was particularly hard it with a high number of incidences of malarial fever. His remedy drew on ancient techniques, known to Egyptian peasants, the idea according to Ross was “drainage reduces malaria.” Thus, draining and cleaning of marshes/waterways, as well as weekly home inspections of every house in both towns, were established. Malaria prevention was also plagued by the difference in legal status between Ismailia and Port Sa‘id. Work in Ismailia was easy due to the original concession of 1856 that stated the town was the property of the Suez Canal Company, thus the company could require the entrance to homes by inspectors. In Port Sa‘id, which was not company owned, but governed by the capitulations and required the approval of residents, the malaria campaign began in 1906 with the help of Governor Abadi Pasha, advertisements in the local press and the Sanitary Inspector. When work began in the “insanitary town,” homes with open cesspools in basements were filled in, sitting water was removed, on top of weekly inspections of each home. Shortly, the “fever” in Port Sa‘id which had plagued residents during the summer months disappeared. Through Ross’s writings, inspection maps, additional archival photographs, and Suez Canal Company documents I examine the interrelated connections between water, cesspools, indoor plumbing, urban infrastructures, sewage systems, marshes, health, malaria, and mosquitos, literally a history of these two urban settlements from below. I argue that an interdisciplinary methodology, environmental and urban histories, will strengthen urban history in general, and add a new narrative to the history of water, health and disease in modern Egyptian historiography.