To examine household food insecurity and hunger in Sidama Zone, one of the most populous zones in southern Ethiopia. Cross-sectional survey administered individually by trained interviewers. Food insecurity was calculated with both the Household Food Insecurity Access Scale (HFIAS) and the Household Hunger Scale (HHS), developed by the Food and Nutrition Technical Assistance Project. Rural households from ten kebeles (the smallest administrative district) selected from two agro-climatic zones in Sidama, southern Ethiopia, from December 2010 to January 2011. Men and women respondents from 1094 rural households were selected using multistage sampling techniques. Using the HFIAS, 17·7 % of households were food secure. The percentage of households that were mildly, moderately and severely food insecure was 6·8 %, 27·7 % and 47·8 %, respectively. Using the HHS, 29·0 % and 5·6 % of households fell into the moderate and severe household hunger categories. Using multivariate statistical techniques, five variables were significant predictors of both food insecurity and hunger. These variables were migration of a household member, agro-climatic zone, and younger age, less education and lower radio access for the woman. Being eligible for safety-net credit programmes also was a predictor of hunger, while limited animal ownership and household wealth as well as alcohol use by the household head added to the prediction of food insecurity. The study documented that food insecurity is a major concern of smallholder farming households in the study area. A substantial majority of the households were facing mild to severe food insecurity and hunger for an extended period of time.