Tatopani Hospital is a new 1,675 square meter public medical facility located in the remote, high-altitude district of Jumla in western Nepal. Earth-sheltered by the site’s topography, with south-facing windows and clerestories to maximize natural light and solar gain, the Hospital is constructed of rammed earth walls from local soil. A solar array offsets the facility’s electricity usage. Tatopani Hospital expands access to affordable healthcare for residents of one of Nepal’s most inaccessible and impoverished regions, and models a net-zero, low-carbon architecture for the Himalayas.