This article addresses the role of disability and disabled people in the construction of citizenship and nation through the ideologies and practices of charity from the 1870s through the 1940s. These periods of Guatemalan history are generally thought of as distinct: the Liberal triumph over Conservatives, Liberal dictatorship, and democratic revolution. To the contrary, practices of charity reveal the continuity of these political forms. This article explains the three models of charity that characterized modern Guatemala—caridad, beneficencia, and asistencia social—and outlines how they reflected understandings of the relationship between individuals and the state. It also provides a window into the daily lives of patients at the nation's insane asylum, leprosarium, and general hospital, who were not merely objects of charity but also political subjects who engaged charity models to gain access to resources, people, and mobility. In sum, this article integrates disability into broader historical narratives.