During the War in China (1937–1945), the Japanese military combined warfare with the maintenance of a military occupation. To sustain its tentative grasp over the occupied territories, the Japanese military vied to cultivate trust among the local population. This was a challenging task in the midst of a violent war which as many historical works described was accompanied by brutal war crimes. A less explored aspect of the occupation was medical care. This article unfolds this history by analysing medical encounters between Japanese military medics and military affiliated agents, and members of the local population in the rural Chinese countryside. Testimonies reveal that these encounters – some spontaneous and others deliberate – were small moments of humanity and benevolence within a violent environment. Concomitantly, they demonstrate the overarching tension in this unequal encounter and the use of medicine as a pacifying tool that also served as means to build and maintain the occupation through the transference of medical trust towards the military at large. Thus, this article presents a different aspect of the role of trust and distrust in medical care, as well as expanding the analysis of medicine as a ‘tool of empire’ to the context of military occupation.