The tribals of the Orissa not only deserve a sustainable form of livelihood, but also proper access to adequate health care facilities, as poverty and morbidity go together to cause vicious circle. Because of a higher incidence of poverty, tribals fail to acquire adequate calories, nutrition and vitamins to keep them immune from various diseases. On the other hand, poverty further diminishes their earning capability due to the affliction of various seasonal and endemic diseases round the year. Hence, for the capacity building of poor tribals to enable them to come out of the poverty trap, apart from livelihood-sustaining measures in an era of economic liberalisation and globalisation, strengthening of public health care facilities in tribal areas needs foremost attention. More so as tribals are usually found to be residing in environmentally adverse and physically less accessible areas, with scattered human settlements, and are more vulnerable to various types of endemic, contagious and seasonal diseases due to mass poverty, ignorance and absence of proper health care in-frastructure and services. Based on the field data collected on different occasions in different tribal districts of Orissa for various research studies and also from published secondary data, this article makes an attempt to analyse the livelihood patterns and living conditions of the tribals of Orissa, and the concomitant morbidity and status of health care services in the tribal regions of the state. The article also critically examines the existing health care policy of the state and its efficacy and relevance for the downtrodden in the present context of economic reforms, and the withdrawal of the state from subsidised health care services.