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This study explains why the responses to bubonic plague outbreaks in San Francisco and Honolulu differed during the late 19th and early 20th centuries. Both Chinatowns served as the epicenter of the outbreaks. However, the organization of those Chinatowns differed significantly in ways that make the divergent responses in the cities puzzling. San Francisco’s Chinatown operated as a traditional ghetto, one subject to strict rules that included requirements for Asian workers to live there. In contrast, Honolulu’s Chinatown operated more like an ethnic enclave, where community members had greater freedom of movement, a flexibility that reflected the higher level of integration of Asian workers within Honolulu. Existing theories would lead us to believe that San Francisco’s more marginalized Asian community would be more vulnerable to an oppressive political response to the outbreak (Massey 1993; Morello-Frosch et al. 2011; Wirth 1927). However, the opposite was the case. San Francisco opted to condemn buildings and fix public health issues in its Chinatown, while in Honolulu, authorities opted to burn the neighborhood. Why was the more marginalized Asian community given reforms while the less marginalized community burned? To answer this puzzle, I draw on archival and secondary historical data to reconstruct the outbreak and response to the plague in both cities. The analysis will examine how city governance, social dynamics, and community resilience interact with anti-Asian sentiment during pandemics. Doing so will allow me to update existing theories to better account for the puzzling pandemic responses of these plague outbreaks at the turn of the twentieth century.