In this Article, Victoria Nourse selects Buck v. Bell as the Supreme Court’s worst decision and argues that the decision upholding Virginia’s compulsory sterilization law in 1927 reinvigorated the nation’s eugenics movement, leading to the forced sterilization of thousands of Americans. According to Nourse, Buck is a constitutional tragedy because it so easily could have come out the other way. At the time, many state courts were finding eugenic sterilization statutes unconstitutional, and the plain language of the Equal Protection Clause suggested that such laws were invalid. To understand Buck, Nourse suggests that we must look to an older era of constitutional jurisprudence where the state police power was seen as supreme, and even the most sacred individual rights could be sacrificed in the name of the health, safety, and welfare of society. Nourse argues that this era of constitutional law was fundamentally at odds with the plain meaning of the Fourteenth Amendment, which, at the very least, forbids government recognition of a born aristocracy.