Open-ended interviews with providers, administrative staff and patients in one teaching hospital and two peripheral hospitals in Mumbai were conducted to investigate the triggers to violence against hospital staff, the underlying conditions that give rise to such conflicts, the structural and organisational factors that contribute to these conditions, the steps taken to reduce the hostility towards the public health system and what needs to be done. Our findings indicate that the violent incidents are usually triggered by sudden deaths. Patients are frustrated by rude health providers and a lack of essential drugs and diagnostic equipment. On their part, resident doctors must provide life-saving treatment while also handling agitated crowds. They live and work in conditions that put them under pressure and keep them demoralised. Bad working conditions, overcrowding and inadequate facilities are responsible for the increased friction between patients and providers.