This paper explores the extent to which government-run cash transfer programs in four sub-Saharan countries affect food security and nutritional outcomes. These programs include Ghana’s Livelihood Empowerment Against Poverty, Kenya’s Cash Transfer for Orphans and Vulnerable Children, Lesotho’s Child Grants Program and Zambia’s Child Grant model of the Social Cash Transfer program. Our cross-country analysis highlights the importance of robust program design and implementation to achieve the intended results. We find that a relatively generous and regular and predictable transfer increases the quantity and quality of food and reduces the prevalence of food insecurity. On the other hand, a smaller, lumpy and irregular transfer does not lead to impacts on food expenditures. We complement binary treatment analysis with continuous treatment analysis to understand not only the impact of being in the program but also the variability in impacts by the extent of treatment.