In Peru, the processes associated with population growth and the expansion of public assistance demanded the specialization of new technical knowledge for the planning and execution of sanitary works. In this context, sanitary engineering began occupying spaces in the programs to combat tropical diseases and basic urban and rural sanitation. Through the analysis of specialized engineering and health journals, as well as memoirs, reports, and other unpublished and published documents, this article examines the transformation of Peruvian health institutions and how this process permitted the gradual incursion of sanitary engineers into the public health field. At the same time, it analyzes the dynamics between national and international actors that allowed the institutionalization and professionalization of sanitary engineering between 1900 and 1962.