A substantial portion of the world's people have not made adequate progress toward overcoming hunger or achieving sustainable livelihoods. The classic approach to addressing chronic food insecurity has been a strategy of agricultural development, supplemented by humanitarian assistance in the event of a shock or crisis—an approach predicated on assumptions that do not fit the context of protracted crises. This article describes protracted crises and argues that they are sufficiently different to warrant special consideration, but there are unique constraints to engagement in protracted crises. The article explores the constraints promoting sustainable livelihoods in these contexts and proposes elements of an alternative approach. It evaluates the limited evidence available about such an approach and outlines important questions for further research.