The status of food and nutrition security and its underlying factors in the Hindu-Kush Himalayan (HKH) region is investigated. In this region, one third to a half of children (<5 years of age) suffer from stunting, with the incidence of wasting and under-weight also being very high. The prevalence of stunting, wasting and under-weight in children is particularly high in some mountain areas such as Meghalaya state in India, the western mountains and far-western hills of Nepal, Balochistan province in Pakistan, eastern Afghanistan, and Chin state in Myanmar. Food habits in the HKH region are changing. This has led to a deterioration in traditional mountain food systems with a decline in agrobiodiversity. Factors such as high poverty and low dietary energy intakes, a lack of hygienic environments, inadequate nutritional knowledge, and climate change and environmental degradation are also influencing food and nutrition security in the HKH region. To achieve sustainable food and nutrition security in the mountains, this study suggests a multi-sectoral integrated approach with consideration of nutritional aspects in all development processes dealing with economic, social, agricultural and public health issues. © 2017 Society of Chemical Industry.