The Horn of Africa includes Ethiopia, Djibouti, Eritrea, Kenya, Somalia, Sudan and Uganda and is the poorest region on the continent. More than 40 per cent of the population of over 160 million is living in areas prone to extreme food shortages (FAO, 2011). In mid-2011 the world became witness to a widespread food crisis in the Horn of Africa, which has escalated into acute shortages of food notably in the regions of southern Somalia, northern Kenya, southeastern Ethiopia and Djibouti. The U.N. Humanitarian Coordinator for Somalia on July 20 declared that severely reduced food access, acute malnutrition, and high crude mortality rates indicate ongoing famine conditions in the Bakool and lower Shabelle regions in southern Somalia (UN, 2011). USAID estimates that 2.8 million people in southern Somalia and 12.4 million people in Djibouti, Ethiopia, and Kenya require immediate, lifesaving humanitarian assistance (USAID, 2011). Furthermore, more people in Eritrea, Uganda, Sudan and South Sudan are also facing a worrying food situation. The causes of food crisis are both environmental, structural and avoidable factors have taken in a broader spectrum of problems affecting the region. This paper addresses in detail some important causes and aggravating factors of famine in Horn of Africa and recommend possible interventions to tackle food shortage and famine in a sustainable way.