This is the first systematic account of early mission medical activities in the Malawi Region (comprising present day Malawi, north eastern Zambia and the eastern shore of Lake Malawi). It compares the policies and practices of three missions - Livingstonia, Blantyre and the UMCA - between 1875 and 1914, from pioneering medical provision through to the establishment of hospitals and participation in largescale public health campaigns. The study acknowledges Megan Vaughan's important analysis of the discourse of missionary medicine, but suggests the need to reflect the different religious and professional influences informing the practice of individual mission doctors. The study further suggests that the organisation and professionalising of medicine within the three missions, from 1900, was dependent upon the activities of those doctors who prioritised their professional rather than their evangelising roles. The study also considers the important contribution of missionary nursing personnel and African medical assistants in delivering both hospital and out-patient services, and identifies the professional, gender and racial factors which influenced their status and roles. The study also considers, as far as sources allow, the African patient's experience of missionary medical services. In particular, it identifies the key role of referring agents, such as African medical assistants and European employers, in directing African patients to mission medical services. It suggests that, in contrast to the conflict in belief systems presented by the mission medical discourse, Western medicine was incorporated alongside indigenous treatments within a plurality of healing systems. Finally, the study assesses the impact of missionary medical provision within the Malawi region up to 1914. It demonstrates that, during the period of this study, the Blantyre, UMCA and Livingstonia missions remained the principal sources of both curative and palliative Western medicine for the African sick, contributing towards the wider development of the missions and the European settler economy.