The Food and Agriculture Organization of the United Nations (FAO) and the World Food Programme (WFP) warn that acute food insecurity is likely to deteriorate further in 18 hunger hotspots – comprising a total 22 countries – during the outlook period from June to November 2023. Afghanistan, Nigeria, Somalia, South Sudan and Yemen remain at the highest concern level. Haiti, the Sahel (Burkina Faso and Mali) and the Sudan have been elevated to the highest concern levels; this is due to severe movement restrictions of people and goods in Haiti, as well as in Burkina Faso and Mali, and the recent eruption of conflict in the Sudan. All the hotspots at the highest level have populations facing or projected to face starvation (Catastrophe, Integrated Food Security Phase Classification [IPC]/ Cadre Harmonisé [CH] Phase 5), or are at risk of deterioration towards catastrophic conditions, given they have already critical food insecurity (Emergency, IPC/CH Phase 4) and are facing severe aggravating factors. These countries require the most urgent attention. Pakistan, the Central African Republic, Ethiopia, Kenya, the Democratic Republic of the Congo and the Syrian Arab Republic are hotspots with very high concern, and the warning is also extended to Myanmar in this edition. All these hotspots have a high number of people facing critical acute food insecurity, coupled with worsening drivers that are expected to further intensify life‑threatening conditions in the coming months. Lebanon, El Salvador and Nicaragua have been added to the list of hunger hotspot countries, since the September 2022 edition. Malawi, Guatemala and Honduras remain hunger hotspot countries. The deterioration of acute food insecurity in the hunger hotspots occurs in context of a global food crisis. As a result, the countries and situations covered in this report highlight the most significant deteriorations of hunger expected in the outlook period but do no represent all countries with high levels of acute food insecurity. The eruption of conflict in Sudan marks a new spike in global levels of organized violence and armed conflict which have slightly reduced compared to the last edition of this report. Conflict will disrupt livelihoods – including agricultural activities and commercial trade – as people are either directly attacked or flee the prospect of attacks, or face movement restrictions and administrative impediments. In addition, new emerging conflicts, in particular the eruption of conflict in the Sudan, will likely drive global conflict trends and impact several neighbouring countries. The use of explosive ordnance and siege tactics in several hunger hotspots continues to push people into catastrophic levels of acute food insecurity, highlighting the critical role of humanitarian access in preventing the worst outcomes of hunger. Economic concerns continue to drive acute food insecurity in almost all the hunger hotspots. This reflects a global trend already registered in 2022,1 when economic risks were driving hunger in more countries than conflict was.