This paper reviews and reflects on the cholera outbreak that rocked Harare, Zimbabwe, in 2008/2009. We give special attention to the root causes, impacts and debates made by key stakeholders, indicating the political and geographical responses. Based on a desktop study and documentary review, the paper highlights the inadequacy of safe and clean water in most of the suburbs, the collapse of the waste management, water supply and sanitation systems of the city as the major explanations for the scourge. Despite this, Harare remains troubled with the shortage of purification chemicals, making it quite impossible to supply clean and adequate water. The national economic crisis also had a strong bearing against the performance of the public health sector. The paper concludes that sustainable urban health initiatives involving both central and local government will provide a long-term solution to the problems highlighted.