During the 1960s, cities across the United States erupted with rioting. Subsequent inquiries into its sources revealed long-simmering discontent with systemic deprivation and exploitation in the country's most racially segregated and resource-scarce neighborhoods. Urban medical centers were not exempt from this anger. They were standing symbols of maldistribution, cordoned off to those without sufficient economic means of access. In this article, I examine the travails of the world-famous and prestigious Cleveland Clinic after the 1966 riot in the Hough neighborhood on the East Side of Cleveland, Ohio. After years of unbridled expansion, fueled by federal urban renewal efforts, the riots caught the Clinic's leadership off guard, forcing it to rethink the long-standing insularity between itself and its neighbors. The riots were central to the Clinic's programmatic reorientation, but the concessions only went so far, especially as the political foment from the riots dissipated in the years afterward. The Cleveland experience is part of a larger-and still ongoing-debate on social obligations of medical centers, "town-gown" relations between research institutions and their neighbors, and the role of protest in catalyzing community health reform.