ABSTRACT What are the distinctive characteristics of the co-design practices at FabLab Nepal, the first humanitarian FabLab in South Asia? This paper presents select case materials from the project ‘3D Printing for Spinal Cord Injury’ to illustrate how FabLab Nepal operates through collaborative, co-design practices and then reflects on how these observations can enrich a more general understanding of what pluriversal design looks like in practice. Co-design initiatives were developed to suit the local practices and situated knowledge of the project context. What was remarkable was that the participants acknowledged that the co-design approach was not novel, however, they did recognise that its impact was beginning to transform everyday lives, in a gradual transition from survival in a disaster situation to local empowerment and capacity building. In this context, pluriversal design was observed to take the form of knowledge exchange and skills development in the use of printing technology, which gave a voice to the patient’s needs and desires in the design and manufacturing process.