The Nepal civil war (1996-2006) opposed a rural Maoist insurrection and a succession of monarchical regimes and governments. Despite a shift in perception of the conflict post 9/11, the conflict remained largely internal to Nepal with limited international involvement. Over that same period, health indicators in most domains recorded significant improvements including in the areas most affected by the conflict. Building on human rights datasets of violent incidents and systematic oral history in three regions affected to varying degrees by the conflict, this article argues that the health care facilities were instrumentalized by both sides of the conflict as one element of their political and military strategy, while medical practitioners had to juggle the demands of insurgents and security forces. Through 80 interviews conducted in 2020-2021 in situ, this article engages with the apparent paradox of a conflict which did not have detrimental effects on health care overall despite its violence. It then considers how the war, violence and mental health consequences of a decade of terror are now recalled and made sense of some fifteen years after the end of the war. With the former insurgents now running the new republic, grassroots militants remember the war in sometimes nostalgic ways when it comes to their centrality in the Maoist objectives and vision. The healthcare provisions arising from the war sometimes do not match some of the wartime resources deployed by insurgents and counterinsurgents keen to demonstrate their commitment to health provisions as a common good that needed to be made more accessible. Finally, this article reflects on the absence of the concept of attacks on healthcare in contemporary analyses, at a time when the concept was gathering support internationally. In this sense this article charters a paradox of violence and resourcing of health care as well as a pre-paradigm shift analysis of a seemingly outmoded political insurgency.