This article explores the most effective ways to influence nutrition through value chains, based on CARE’s long history in food and nutrition security. With implementation experience in 90 countries and evidence from 11 existing projects, the article argues that the best ways to impact nutrition through value chains and market systems are to focus on gender equality and pay attention to market systems contexts. Furthermore, experience in emergencies programming has different lessons and important caveats to strengthen markets rather than default to subsidised distribution systems.