This article explores the intersection of Black women's health experiences in Canada with the pervasive influence of carceral philosophies in healthcare and social work systems. It highlights how Black women, due to historical and ongoing racial and gendered surveillance, face unique challenges within a neoliberal healthcare system that merges punishment with care. The article underscores the importance of abolitionist approaches in social work and healthcare, advocating for strategies that move beyond punishment towards supportive, community-based care. It calls for a deeper understanding of the socio-economic and racial factors affecting Black women's health and the need for systemic change to address these inequities.