This report traces the evolution of Hamas’s health care services from the movement’s origins to its current role as the de facto government of Gaza. The analysis focuses primarily on the impact of Palestinian divisions on the development of Gaza’s health sector since Hamas’s takeover of Gaza in June 2007, and it examines how regional trends in 2011 have influenced internal Palestinian dynamics that will likely shape Gaza’s health care sector and the Palestinian population more broadly in the future. Finally, the report examines the U.S. policy implications of Hamas’s successful management of health services in Gaza.