The Spanish Influenza of 1918-19 affected everyone on the globe. The first known H1N1 virus, it caused unprecedented morbidity and mortality. Unlike other viruses, its potential for developing into bacterial pneumonia made it especially dangerous in an age without the benefit of antibiotics. When the influenza arrived in New Mexico during the fall of 1918, the state lacked a centralized department of health to assist in combating the epidemic by providing medical assistance and logistics. A proto command center was set up in Las Vegas to monitor the disease and provide medical personnel. However, in the fifth largest state of the U.S., the challenges of distance were compounded by poverty and inadequate roads. Meanwhile, the people of New Mexico mustered traditional reactions to illness and death and dying. But this strain of the H1N1 virus had features that quickly overwhelmed traditional practices. Historical analysis of how New Mexicans in pueblos, on reservations, in villages and in towns coped with the flu and its aftermath out of their cultural responses to illness and death reveals some patterns other historians have identified. However, the indigenous cultural enclaves in New Mexico, only partially touched by modernity, yielded some unique and, sometimes, tragic responses.