The purpose of this article is to investigate the socio-economic as well as the political, institutional, and ideological causes of the Chinese famine of 1959–1961. The main hypothesis of this paper is that the radical policies implemented as part of the Great Leap Forward resulted in agricultural output decline (i.e., availability issues), and in the implementation of an ineffective food distribution policy affecting rural populations (i.e., accessibility issues). An econometric analysis, based on provincial panel data from the 1954–1966 period, stresses the effect of ill-advised economic policies in handling the famine. This analysis also confirms that the increase in mortality rates during the famine was caused by the simultaneous collapse in food availability and food accessibility in rural areas.Great leap forward, Famine, Food availability, Entitlements, Dynamic panel data models, Generalized method of moments