Few career opportunities were available to minority women in Appalachia in the first half of the 20th century. Nursing offered them a respected, relatively well paid profession and—as few physicians or hospitals would treat people of color—their work was important in challenging health care inequities in the region. Working in both modern surgical suites and tumble-down cabins, these women created unprecedented networks of care, managed nursing schools and built professional nursing organizations while navigating discrimination in the workplace. Focusing on the careers and contributions of dozens of African American and Eastern Band Cherokee registered nurses, this first comprehensive study of minority nurses in Appalachia documents the quality of health care for minorities in the region during the Jim Crow era. Racial segregation in health care and education and state and federal policies affecting health care for Native Americans are examined in depth.