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Just how sanitary were cities in North America in the late 19th century? The period was a time of great change in urban sanitary regulations and awareness of public health generally. At the Îlot Hunt site in Québec City, domestic and commercial establishments were investigated and archaeoentomological samples analyzed from two latrines, a drain, and an abandoned well. In total 6755 insects were identified from 48 levels. Through a multidisciplinary contextual analysis, a new view of public health in late nineteenth-century Québec City has been accessed, indicating the value of this approach in historical archaeology. Appendix C features a 12-page, complete listing of all the insect remains recovered from the site.