This research critically examined the impact of Western medicine on the Santhal community during British colonial rule between 1835 and 1947, focusing on the intertwined roles of the colonial government and Christian missionaries. Western medical practices had been introduced not merely for curative purposes but had been strategically integrated into broader colonial and evangelical agendas. Health services, such as dispensaries, vaccination campaigns, and missionary hospitals, had been employed as tools for surveillance, control, and religious conversion. The colonial state had utilized medical interventions to pacify the Santhals, especially following uprisings like the Santhal Hul (1855–56), while Christian missions had leveraged healthcare to promote conversion by associating healing with divine intervention. Indigenous healing practices and the authority of the ojha (tribal healer) had been marginalized, though not completely replaced. The research revealed that the Santhals had responded through selective acceptance, resistance, and adaptation. Medical aid had often been accepted, but conversion had not been universally embraced. The study concluded that Western medicine had been used as both a healing and colonizing force, leaving a complex legacy of medical-evangelical integration in tribal regions of colonial India.