Drawing on case studies from the Democratic Republic of the Congo (DRC), Somalia and Sudan, this paper focuses on policy, programming and institutional issues related to addressing food insecurity in protracted crises and fragile states, with a focus on areas afflicted by conflicts. The case studies illustrate how dysfunctional institutions are at the root of structural food insecurity and show how local people and institutions have been able, to a certain extent, to adapt and cope with the crises. However, the protracted nature of the crises has substantially eroded people’s assets and weakened the capacities of traditional safety net systems to provide protection. Against this background, mainstream humanitarian assistance – which has been the international community’s dominant response – has not been able to address the basic determinants of food security and in particular has not sufficiently supported the positive efforts of local institutions. The case studies illustrate some innovative approaches for addressing food insecurity during protracted crises. They show that while it remains indispensable to ensure neutrality for immediate responses that protect the most vulnerable, it is also crucial to take into account institutional and policy dynamics that support processes to rebuild resilience; create opportunities for strengthening the livelihoods of affected population at the very early stages of the crisis; and develop an adequate basket of interventions to address a variety of needs.