Summary Studies on urban metabolism have provided important insights in the material and sociopolitical issues associated with the flow of water. However, there is a dearth of studies that reveal how infrastructure, as a hybrid of social and material construct, facilitates disease emergence. The article brings together urban metabolism, political ecology, and anthropological studies to examine the social construction and reconstruction of the material flow through everyday practices for addressing the water problem and its health burden in Ahmedabad city. The article georeferences the water problems and occurrence of diseases and, through interviews, documents Ahmedabad's sociospatial characteristics of water problems and health burden in two case study wards. Through a situated understanding of the everyday practices, the infrastructure is exposed through leakages, reveals the citizens desire for better water quality, and struggle to gain access to water using diverse ‘pressure’ tactics. It is these social‐material constructs of water that give structure and coherence to urban space, which spatially coincides with the occurrence of diseases. It reveals the sociopolitical drivers of the water problems and identifies different hypotheses of the hotspots of disease emergences. The methodology offers a way forward for researchers and development agencies to improve the surveillance and monitoring of water infrastructure and public health through an incremental approach that takes into consideration the diffuse interplay of power by diverse actors. It charts out avenues for building on the urban metabolism by emphasizing the importance of examining the sociospatiality of the everyday practices for improving resource use efficiencies in cities of rapidly growing economies.

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