Just over 100 years before the COVID-19 pandemic of the early 2020s spread across the world, the Spanish influenza epidemic had a devastating global impact. By the time World War I peace negotiations in Europe began in November 1918, every state in the U.S. had been invaded by the flu. Originally published by Texas Western Press in 1984, Epidemic in the Southwest, 1918-1919 describes the Spanish influenza’s impact on major cities in West Texas, New Mexico and Arizona. Schools, churches, theaters, and businesses closed. Masks were mandated. Public gatherings were banned. Newspapers urged caution while officials invoked emergency powers to slow the spread. With no effective vaccine or cure, communities relied on quarantine, regulation and sheer determination. Most citizens cooperated, but tensions soon surfaced. Some business owners and newspaper editors questioned closures and mask mandates, warning of economic and social damage. Restrictions were challenged, eased, and reinstated as leaders struggled to balance public safety with civic life. Yet the crisis also revealed extraordinary resolve. Doctors and nurses worked to exhaustion. Volunteers organized soup kitchens and emergency hospitals. Women led relief efforts and cared for the sick. The epidemic exposed the region’s limited public health infrastructure and underscored the need for greater scientific research and preparedness. A century later, the COVID-19 pandemic would echo these same debates over masks, closures and personal freedom, as well as the same reliance on frontline workers and community solidarity. This forgotten chapter of Southwestern history offers a powerful reminder: while medicine advances, the social challenges of confronting a pandemic remain strikingly familiar.