From Antiquity through contemporary times, depriving populations of access to food, water and other means to sustain life has been a central tool of genocide. The deliberate withholding or destruction of objects indispensable to the survival of the civilian population can be used to pursue policies that systematically target groups with an impact equal to, and potentially even more widespread than, acts of killing. However, the acts that produce and sustain starvation are treated as lesser crimes than killing. When described as famine, these calamities are often presented as natural or unintentional crises of hunger or low nutrition. Drawing on historical examples that range from ancient Carthage, colonial famines, the Nazi Hungerplan, Communist agricultural and political policies, manipulation of humanitarian aid during the war in Bosnia, and genocides in the 21st century, this chapter considers the complications of assessing intent and formulating responses to mass starvation. It offers a wide-ranging overview of the critical concepts, legal developments, and key issues at stake when deliberate deprivation is imposed on a people as part of genocidal policies.