Uncovering the true cost of food is the first step in making agrifood systems more inclusive, resilient and sustainable. As The State of Food and Agriculture 2023 revealed, agrifood systems activities generate significant benefits for society, but also have negative impacts on economic, social and environmental sustainability. The quantified hidden costs of agrifood systems amount to around 10 percent of global gross domestic product. Therefore, strategic action is necessary, and all agrifood systems actors – from producers and agribusinesses to consumers and governments – have a crucial role to play. While transforming agrifood systems would yield a net global gain, the benefits and costs would be unevenly distributed among stakeholders and countries over time. The State of Food and Agriculture 2024 builds on the findings of the 2023 edition, delving deeper into the use of true cost accounting assessments of agrifood systems and identifying policy interventions aimed at transformation. Using updated global datasets, the report confirms previous estimates of the quantified hidden costs of agrifood systems and provides a detailed breakdown of the hidden costs associated with unhealthy dietary patterns and non-communicable diseases for 156 countries. These findings are analysed through the lens of six agrifood systems categories to take into account various outcomes and hidden costs that require different policy interventions. Case studies offering in-depth assessments of country, local and value chain contexts illustrate the economic, social and environmental impacts of current practices to guide policy interventions. Crucial to all contexts is the need for inclusive stakeholder consultations to inform interventions and reconcile power imbalances and trade-offs.