Bangladesh, prone to recurrent natural disasters, continually grapples with the repercussions of these events, affecting millions of its citizens each year. Amid the most vulnerable regions in the country, the riverine islands of Sirajgonj, Bangladesh, stand as particularly fragile areas, characterized by limited healthcare access. This study is dedicated to examining the intricate web of healthcare challenges prevailing in these disaster-prone islands. A semi-structured interview methodology was meticulously employed, with a total of 24 in-depth interviews conducted. Thematic analysis, adopting both deductive and inductive approaches, was rigorously applied to dissect the data. The Granheim method, in conjunction with Nvivo-14 software, facilitated seamless data processing, rigorous analysis, and meticulous coding. The findings highlight critical healthcare challenges in Sirajgonj’s disaster-prone riverine islands: residents face knowledge gaps about available healthcare resources, geographical and weather-related barriers hinder transportation, especially during disasters. Moreover, inadequate medical responses and patient distrust underscore the need for healthcare resilience. Socio-economic status affects healthcare access, perpetuating disparities. Shortages of medical support and resources further exacerbate challenges, necessitating urgent targeted interventions. This study provides crucial insights into the barriers to healthcare access in the region, offering valuable guidance for policymakers and healthcare providers. It also suggests that the government should adopt a more efficient approach to integrate the elderly into social safety net programs.