Since the mid-1980s, generations of displaced people have sought refuge in the ramshackle buildings that were once the Gaza-Ramallah Hospital, a multi-story hospital complex built by the Palestinian Liberation Organization (PLO). Damaged during the Lebanese civil war, today the buildings blend in with the run-down Sabra-Shatila neighborhood in Beirut’s “misery belt”. The chapter charts the buildings’ history from hospital to shelter and self-managed squat for Palestinian and Syrian refugees as well as Asian migrant workers. The multi-story buildings are examples of architectures of precarity whereby displaced people settle in poor and underserved urban areas, and the buildings and floors can be visualized as a vertical migration history of people escaping conflict, displacement, and destitution. To analyze the buildings’ and area’s transformation, the chapter combines urban ethnography with maps, historical photographs, and 3D imagery that visualize the temporal and spatial changes of the buildings and the historical settlement of refugees and migrants in Sabra. By analyzing the precarious architectures of place and space, the chapter provides a genealogy of emergency urbanism in Beirut’s Sabra area, a process replicated among refugees settling in low-income urban areas throughout the Middle East.