The persistence of undernutrition and the increasing levels of overweight and obesity worldwide (with their associated societal costs) are calling for a transformation of food systems towards healthier diets. Fruits and vegetables are key components of a healthy diet; however, their consumption is considerably below the minimal levels recommended by the World Health Organization (WHO). This underconsumption is particularly pronounced in low- and middle-income countries and among low-income socio-economic groups in all countries. This paper uses the value chain approach to analyze the factors that affect the availability and affordability of fruits and vegetables. It examines major challenges across the value chain and identifies opportunities for improvement as seen through a nutrition-sensitive lens. Factors that negatively affect the availability and affordability of fruits and vegetables discussed in this paper include low production and productivity, the loss of agrobiodiversity, inadequate technology, logistics and infrastructure, weak organizational, business, and technical skills, and inefficient market linkages across the supply chain. The paper proposes a number of policy recommendations based on insights from documented cases of good practices and on lessons learned in domestic and export-oriented value chains. The paper makes a case for reviving native, underutilized, and neglected fruit and vegetable varieties to improve nutrition and increase agrobiodiversity. In addition, short value chains delivering to local markets are recommended as a resilience strategy for smallscale producers and low-income consumers in the face of climatic and economic shocks.