This study sought answers to a puzzling paradox. Generally, formal legal health care rights for undocumented people in The Netherlands are relatively good, with some exceptions (like dentistry and mental health). Despite this, many undocumented people were found only to access health care services in the case of an emergency, and sometimes not even then. Why were undocumented people not fully making use of their legal rights to access health care? Was it due to discrimination? A lack of information? Or some other deterrents? This article presents findings from a project entitled: “Count Us In”: Towards Realising Health Rights among Undocumented People in Two Dutch Global Cities”, funded by the Rotterdam Global Health Initiative (RGHI). Using the Participatory Ethnographic Evaluation and Research (PEER) methodology, research was conducted in The Hague and Rotterdam between 2012 and 2015. The study found that those in work or socially embedded in support netw