International food aid has rightly been credited with saving millions of lives and is often the only thing that stands between vulnerable people and death. However, it was a serious obstacle in the Doha Round of multilateral trade negotiations and has been sharply criticised as a donor-driven response that creates dependency on the part of recipients and undermines local agricultural producers and traders upon whom sustainable food security depends. This issue of the 'State of Food and Agriculture' report examines the issues and controversies surrounding international food aid, particularly in crisis situations. It considers the ways in which food aid can support sustainable improvements in food security, in order to preserve its essential humanitarian role whilst minimising the possibility of harmful secondary impacts.