BackgroundIn 2019, a migrant camp on the Greek island of Samos designed for 650 people was home to over 5500. Migration rates from conflict zones remain high. We aimed to quantitatively describe demographics, living conditions and health needs in the reception centre community of Samos, Greece.MethodsA questionnaire was designed with reference to international humanitarian standards for reception centre following a consultative process with representatives of the asylum-seeker population. Domains assessed included demographics; living conditions; safety/vulnerability; and health. The questionnaire was piloted and then following feedback from participants, conducted in June 2019 on a sample of 500 asylum seekers attending Non-Governmental Organisation (NGO) centres supporting the Samos reception centre. Results500 participants: 60.6% male, 35.0% female and 4.4% did not report gender. 79.4% lived in tents. Respondents were predominantly from Afghanistan and the Democratic Republic of Congo (DRC). Respondents reported a total of 570 children in their care. 20.6% of women were pregnant. 35.4% had experienced physical violence; 7.8% reported Sexual/ Gender-based violence (SGBV). 83% reported psychological distress, 71% skin disease, 66% diarrhoea and vomiting and 64% respiratory disease. Accommodation, sanitation, and nutrition fell below internationally recognised standards, and poor access to water was significantly associated (p < 0.001) with respiratory disease, diarrhoea and vomiting, skin disease and psychological distress. ConclusionLiving conditions in the over-burdened Samos camp fall far below accepted basic humanitarian standards and are associated with overall poor health status in the camp population. Further research is imperative to analyse and monitor the diverse, varying needs of asylum-seekers in the Greek island hotspots and inform policies to improve conditions.