The municipality of Sandnes became a separate medical district in 1866. The district physicians' reports give us an insight into health and living conditions in this district in the last half of the 19th century. This paper is based on a study of all statistical data and physicians' comments concerning the Sandnes district for the 1866-1900 period. The incidence of various diseases is estimated. Mental illness seems to have been more frequent in Sandness than in the rest of the county. In the physicians' reports, this was explained by the dominance of religious Puritanism in the district. The incidence of other disease, such as typhoid fever, tuberculosis and scarlet fever, did not differ essentially between Sandnes and the county as a whole. The living conditions in the district were rather good during the whole period, though the physicians' reports provide interesting insight in changes from one year to another.