This paper discusses the impact of sociocultural exclusion influences and biographical disruptions on adolescents moving into street involvement associated with hazardous medical waste scavenging. Data were collected in Dhaka, Bangladesh, using a variety of qualitative techniques, including adaptive sampling for roaming populations. Observation distinguished a distinct group of people ('medical waste scavengers') who were involved in unauthorised scavenging and reselling of medical waste. This trade is linked to homelessness, sexual abuse and drug use. These individuals have given accounts of underprivileged family backgrounds, exclusion due to ethnicity or caste, and of horrific experiences through early childhood and adolescence. From this difficult position, they have demonstrated flexibility and resilience to develop the street competence required to survive by specialising in scavenging extremely hazardous items to be repackaged and resold to the community.