This publication documents thirteen case studies from city regions around the world which are developing CRFS projects, programmes, and policies, including those related to the prevention, reduction and management of food waste. Lessons learned from the case studies for sustainable development of CRFS call for local, city regional, and (sub) national governments to institutionalise city region food systems, providing them an institutional setting and budget, linking them to larger city region development plans, and monitoring their developmental impacts across urban and rural areas. They also call for (sub)national and legal frameworks which embed CRFS within broader legislation, specifically the ‘Right to Food’ and the ‘Right to the City’, acknowledging the need to guarantee both urban as well as rural food and nutrition security, as well as to regulate (unplanned) urban expansion on agricultural land in order to safeguard food and ecosystem services. The selected cases also highlight the need to strengthen horizontal and vertical governance systems as well as multi-stakeholder and cross-sectoral partnerships.