COVID-19 was a fundamentally unequal pandemic. Mortality and morbidity rates were higher in more deprived areas, amongst poorer people, among minoritised communities, and in urban compared to rural areas. Emergency measures taken to contain the virus also affected people unequally, reflecting pre-existing social and economic fault lines, as did the global economic crisis that followed the pandemic. The chapter focuses in particular on the first year of the pandemic, when most governments and societies were least well prepared. We show how the unequal pandemic laid bare the consequences of social, economic, and health inequalities, inadequate social policy, and austerity, and argue for treating it as a syndemic—a concept developed by medical anthropologist Merrill Singer to describe how vulnerabilities interact and reinforce one another. The chapter concludes with some lessons from past pandemics, and with a forward look at the potential consequences of inequalities magnified during the pandemic.