This report provides a comprehensive assessment of food insecurity dynamics in Appalachia—primarily through analysis of datasets from Feeding America, the American Community Survey (ACS), and the U.S. Department of Agriculture (USDA). It highlights the realities, risks, and opportunities related to food insecurity in the region. The report also offers case studies of a range of innovative responses to food insecurity from across the Appalachian Region. Each case study summarizes the context, rationale, and key elements of the initiative, while also providing relevant takeaways and lessons learned to inform stakeholders in other regions that may want to replicate or adapt these approaches.