Historical accounts of famines in Ethiopia go as far back as the 9th century, however, evidence on its impact on health only started to emerge from the 15th century onwards. Unfortunately, famine has been endemic in Ethiopia in the last few decades. The 1973 famine is reported to have claimed over 300,000 lives. In 1985 approximately 10 million people were reported to be starving, with approximately 300,000 already dead and about 1000 dying daily. In the following years, droughts leading to food shortage have had local and national adverse health effects, in particular in 1999/2000. This paper describes the initial findings of a literature review of evidence on the health impact of droughts leading to famine in Ethiopia and highlights gaps in knowledge. The key finding, thus far, is the marked paucity of health impact data. This review also highlights the fact that adverse health impacts of famines are probably complex and long lasting. Interpretation of any health impact data is difficult as there are few baseline data to compare. Health effects also impact livelihoods. Livelihood disruption following famine does not just affect one generation but also subsequent generations. Surveillance systems are needed so that records of the health impacts of a drought that leads to famine can inform action. With climate change bringing increased likelihood of drought and famine in some parts of the world, the findings of this review could be beneficial not just for Ethiopia but also elsewhere.