The United Nations Decade of Action on Nutrition 2016-2025 and the 2030 Agenda for Sustainable Development call on all countries and stakeholders to work together to prevent all forms of malnutrition by 2030. In Nepal, these considerations are at the forefront of the country's Sustainable Development Goals. To aid in this effort, this article presents a case study from the mountainous Humla District, Nepal, that was designed to better understand how the arrival of the first road in this area is affecting food security and nutritional status, and how these 2 variables are interrelated. Data from participant observation, interviews, the Household Food Insecurity Access Scale questionnaire, and a region-specific food frequency questionnaire suggest that while the road provides more reliable access to market-sourced food than before, villagers' intake of many micronutrients remains below recommended levels, as most of the market-purchased foods are nutrient poor. Data also suggest that this population is experiencing the double burden of malnutrition: Simultaneous cases of underweight and overweight. High food security levels among those in the malnourished/overweight group could easily mask this emerging public health concern. This study provides an analytical framework to better understand the nexus of food security and nutrition, and offers evidence-based recommendations for decreasing food insecurity and malnutrition in mountainous regions, which will help achieve the goal of preventing all forms of malnutrition by 2030. © 2018 Grocke and Haddix McKay.