Little research exists on the environmental history of Palestinian refugee camps in Lebanon though limited cross-sectional studies suggest that environmental health status in the camps is predominantly poor. The present work studies the environmental history of Shatila, an urban camp in Beirut in order to describe conditions in the camp at the time and to elucidate policies, practices, and discourses that contributed to environmental conditions. Three dimensions of the built environment of Shatila and more broadly all refugee camps in Lebanon were examined for the first two decades of Palestinian displacement, 1949-1969, in the country. Dimensions of the built camp environment that were assessed were food security, housing conditions, and the state of water and sanitation (WASH). Environmentally-influenced health outcomes in the camps were likewise reviewed. It was found that the primary sources of food in the camps were rations provided by the UNRWA and other aid agencies, and that food rations were inadequate both calorically and nutritionally. Housing conditions were subpar, with most camp residents residing in tents or flimsy huts. Lebanese state policies that strictly forbade the construction of more solid permanent shelters. WASH conditions were found to be poor with no running water, no sewage infrastructure, and no private sanitation facilities. As a result, rates of malnutrition and growth disturbances, waterborne diseases and parasites, infectious disease, and health conditions due to exposure to the elements and weakened overall health, were found to be high. Several predominant discourses on causes of the poor camp conditions were identified. Most discourses neglect policies and practices of the Lebanese state and aid agencies that impacted the environmental dimensions considered herein. Primary policies and practices were found to be a ban on work permits to Palestinians which created dependency on aid, and a ban on construction and the basic infrastructure necessary for healthy housing and sanitation. Results of this study suggest the need for more complex environmental analyses in settings impacted by conflict and displacement and the importance of political factors for material deprivations observed when studying environmental problems.