This paper describes the results of an investigation into how the December, 2004 tsunami and its aftermath affected the human rights of the survivors. Teams of researchers interviewed survivors, government officials, representatives of international and local nongovernmental organisations, UN officials, the military, police, and other key informants in India, Sri Lanka, the Maldives, Indonesia, and Thailand. We also analysed newspaper articles, reports released by governments, UN agencies, NGOs, and private humanitarian aid groups, and we examined the laws and policies related to survivors’ welfare in the affected countries. We found worsening of prior human rights violations, inequities in aid distribution, lack of accountability and impunity, poor coordination of aid, lack of community participation in reconstruction, including coastal redevelopment. Corruption and preexisting conflict negatively impact humanitarian interventions. We make recommendations to international agencies, states, and local health service providers. A human rights framework offers significant protection to survivors and should play a critical role in disaster response.