In this article the Queensland government's response to suspected and confirmed cases of venereal disease amongst the state's Aboriginal population is examined through the micro history of Fantome Island lock hospital, which operated between 1928 and 1945. This history offers an interesting case study into the complexities of medical and racial segregation in twentieth century Queensland. While other scholars have positioned Fantome Island lock hospital as a justifiable attempt to control syphilis and gonorrhoea infections amongst the Queensland Aboriginal population, I propose a different interpretation and argue that white perceptions of Aboriginal sexuality and health contributed to government depictions of an Aboriginal venereal disease 'epidemic.' I demonstrate that disease diagnosis was still highly problematic prior to World War II and was differentially applied across different sub-populations.