Introduction: Homeless populations in EU and USA presents an increasing demographic. Social pathology includes substance or alcohol abuse, family and unemployment distress, and several other factors resulting to poverty and homelessness. Patients and Methods: The purpose of this study was to analyze the spectrum of both communicable and non-communicable diseases in two different urban environments: Large metropolitan area (BA) versus small regional town (NZ); one with 500,000 and other with 50,000 population. Results: Between January 2014 to December 2019, 9,896 homeless patients in Bratislava and 299 in Nove Zamky were analyzed for the spectrum of communicable and non-communicable disieases. Commonest ID had seasonal occurrence; respiratory tract infections (RTI) in November to March, and gastrointestinal from June to September. Conclusion: Vaccination of all homeless should be considered to prevent RTI TB, HIV, HCV in shelters