The Food and Agriculture Organization of the United Nations (FAO) and the World Food Programme (WFP) warn that acute food insecurity is likely to deteriorate further in 18 hunger hotspots – comprising a total of 22 countries or territories including 2 regional clusters – during the outlook period from November 2023 to April 2024. Burkina Faso, Mali, South Sudan and the Sudan remain at the highest concern level. Palestine was added to the list of countries/ territories of highest concern due to the severe escalation of conflict in October 2023. These hotspots have populations that are facing or projected to face starvation (Catastrophe, Integrated Food Security Phase Classification [IPC]/Cadre Harmonisé [CH] Phase 5) or are at risk of deterioration towards catastrophic conditions during the outlook period, given they have populations already facing critical food insecurity (Emergency, IPC/CH Phase 4) and are facing severe aggravating factors. These countries require the most urgent attention.