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Xenophobic attitudes and actions are all-pervasive in South Africa in civil society and the state. Medical xenophobia refers to the negative attitudes and practices of health professionals and employees towards migrants and refugees based purely on their identity as non-South African. This paper examines the extent to which xenophobia manifests itself within the public institutions that offer health services to citizens and non-citizens, based on primary research with Zimbabwean migrants who try to access the system. The paper argues that medical xenophobia is deeply entrenched in the South African public health system despite being a fundamental breach of the country's Constitution and Bill of Rights, international human rights obligations and the existence of professional codes of ethics governing the treatment of patients. [ABSTRACT FROM PUBLISHER]