Approximately half of all slums(1) in India are not recognized by the government. Lack of government recognition, also referred to as “non-notified status” in the Indian context, may create entrenched barriers to legal rights and basic services such as water, sanitation and security of tenure. In this paper, we explore the relationship between non-notified status and health outcomes in Kaula Bandar, a slum in Mumbai, India. We illustrate this relationship using the findings of a four-year long series of studies in the community. By comparing Kaula Bandar’s statistics with those from other Mumbai slums captured by India’s National Family Health Survey–3, we show that Kaula Bandar has relative deficiencies in several health and social outcomes, including educational status, child health and adult nutrition. We then provide an explanatory framework for the role that Kaula Bandar’s non-notified status may play in generating poor health outcomes, by discussing the health consequences of the absence of basic services. We also highlight the criminalization by the government of activities necessary for fulfilling access to fundamental needs such as water, toilets and shelter. We argue that the policy vacuum surrounding non-notified slums such as Kaula Bandar results in governance failures that lead to poor health outcomes. Our findings highlight the need for cities in India and other developing countries to establish and fulfill minimum humanitarian standards in non-notified slums for the provision of basic services such as water, sanitation, solid waste removal, electricity and education.