José Ramón Machado was born in San Antonio de las Vueltas, in the former province of Las Villas, and was schooled in Camajuaní and Remedios. He is a medical doctor by profession, graduating from the University of Havana in 1953. Machado joined the revolutionary movement immediately following Fulgencio Batista's coup d'état of 10 March 1952, while still a medical student, and was an early member of the 26th of July Movement opposing the dictatorship. Later, under the command first of Ernesto "Che" Guevara and subsequently of Fidel Castro, he was one of the original revolutionaries who fought the guerrilla war in the Sierra Maestra. In 1958, promoted to the rank of captain, he was sent to the province of Oriente under the command of Raúl Castro as part of the rebels' bid to open up a second front. There he was placed in charge of the guerrillas' medical service, establishing a network of hospitals and dispensaries, and was promoted to the rank of major "comandante" (top rank on Castro's rebel army).