Unlike the rest of Bangladesh, the Chittagong Hill Tracts (CHT) has a substantial population of indigenous peoples (IP), known as the Paharis, against whom the state had conducted counter-insurgency operations until the signing of a Peace Accord in 1997. This chapter aims to provide a brief analysis of the factors determining the changing livelihood options and food security of the Pahari peoples over the preceding decades (1960–2020). The Pahari communities face acute food shortages due to episodic or one-shot disasters, as well as recurrent or periodic crises. Traditionally, they have coped with these by making adjustments in household consumption and extracting ‘wild’ food from forests and wetlands. However, these survival strategies have come under increasing pressure because ecological reserves have been subject to agro-ecological degradation since the disruptive impacts of the Kaptai hydroelectric project in the 1960s. Superimposed upon these aggregate trends of declining resources have been the adverse distributive impacts of land grabs taking place through state acquisition and private encroachment. In addition, distress borrowing by the IP, entailing payment of exorbitant interest, has reduced familial consumption, if not also loss of land held as collateral for debt settlement. These varied processes of primitive accumulation have deprived the Paharis of access to their means of livelihood and food security.Correlatively, lack of access to adequate education and medical facilities has undermined not only the capability of Paharis to enhance current incomes and food security, but also their long-term strategy of intergenerational upward mobility. While their solidary organization and egalitarian redistributive norms have historically enabled them to cope with food shortages and insecurity, its social bases has been gradually undercut by loss of common lands and resources, as well as the emergence of self-interested behaviour among their elites. The structure of causation underlying the deteriorating livelihood options and food security of the IP is therefore multi-factorial, subsuming social, economic and political factors, with state repression, ethnic discrimination, and direct and structural violence constituting the key antecedent determinants. The crises of livelihoods and food security facing the Pahari ethnic groups of the CHT is likely to persist, if not worsen, in the foreseeable future. If the IP communities now sheltering in the remote Reserve Forests are displaced yet again by ethnic violence and land grabs, they may be compelled yet again to flee across the international border into adjoining areas of India and Myanmar.