The working assumption in most Vehicle Routing Problems (VRPs) is that profitable customer requests have to be processed at minimal cost. However, there are VRP applications where servicing a customer has no monetary benefit, but all available resources must be mobilized to provide the best possible service. These applications appear in the context of humanitarian relief, where the key principle is to prevent or alleviate human suffering. This chapter examines a class of problems that obey this principle, namely, VRPs in disaster relief operations.We define a disaster as an extraordinary event that can occur with or without limited forewarning and has devastating effects on the population. Disasters might have different causes: natural (e.g., earthquakes and hurricanes) or man made (e.g., terrorist attacks and industry disasters). Furthermore, one disaster may be the trigger for another, such as an earthquake leading to a tsunami and a tsunami causing an industrial accident. Regardless of the cause, disasters often bring destruction, suffering, and loss of lives at a level that cannot be managed by local emergency units. The severity of the impact on the victims depends on the event's magnitude and on two additional factors (International Federation of Red Cross and Red Crescent Societies [23]): the affected population's vulnerability, expressed as the inability to resist the hazard, and the available capacities to cope with the effects of the event. As local capacities are overwhelmed after a disaster, national and international aid agencies play an important role in providing the support that is required to alleviate the suffering. Even though local authorities are responsible for the relief operations, the aid agencies are heavily involved in the disaster management process. Their functions include deploying rescue teams and providing essential supplies such as water, food, and medicine to the affected regions.Research in the field of disaster relief routing can make important contributions to support aid agencies in their operational activities and eventually to help save lives.