The influenza pandemic of 1918-19 wreaked havoc all over the world, and Bihar, where more than a million people died, was no exception. The pandemic became more lethal in Bihar relative to what we know of other states in eastern India. Why did rural mortality surpass urban mortality? How did the pandemic worsen the socio-economic crisis in the years that followed? This study examines the socio-economic context of the pandemic in Bihar at a micro-level and investigates how the pandemic became unbearable for the people due to a severe economic crisis that resulted from the war and failed monsoons, among other factors. It seeks to explain the manner in which factors such as agricultural failure, inflation, high population density and poor health infrastructure resulted in higher rural mortality. It also shows how the loss of the younger generation and forced migration during the pandemic resulted in a lower rate of birth in the years following the pandemic, resulting in a loss of the labour force and worsening of the agrarian crisis.