Faced with both flooding and drought in successive years, the population of Sindh province in south-eastern Pakistan is highly vulnerable to shocks and extremely food insecure. Concern Worldwide and Welthungerhilfe implement a programme in Sindh which aims to increase the resilience of those households who are worst-affected by repeated flooding and drought. In 2015 FEG was commissioned by these organizations and the Food Security Cluster in Pakistan to assess livelihoods in the districts of Jamshoro, Umerkot and Tharparkar in Sindh. Two FEG consultants trained members of the cluster in HEA data collection and led two rounds of fieldwork. The results showed a significant gap between what poor households need to survive (the HEA survival threshold) and what they actually had access to in the year under analysis. The study demonstrated the need for immediate humanitarian assistance, so that households would no longer face a survival deficit, in addition to a longer-term focus on livelihoods and resilience.