With the increasing likelihood of local agricultural production failures under a warmer and more erratic global climate, the importance of markets in providing affordable and equitable access to nutrient-dense foods through trade is predicted to strengthen. Consequently, regions with relatively poor access to markets and supporting infrastructures (e.g., roads and storage facilities) are potentially ill-equipped to deal with both short-term hydrometeorological hazards such as droughts and floods, and longer-term shifts in agricultural productivity associated with multidecadal changes in temperature and precipitation. To this end, we conduct a novel exploratory geospatial analysis of three newly compiled datasets to understand the extent to which hotspots of climate vulnerability and market inaccessibility coexist across four neighbouring states of India (Bihar, Chhattisgarh, Jharkhand, and Odisha), as defined by three market access measures: (i) distance from a settlement to its nearest village, town or city with a market, (ii) distance from a settlement to its nearest major road, and (iii) distance from a settlement to its subdistrict headquarters. We find that the three market access measures are both spatially autocorrelated and positively interrelated at both the settlement (n = 129,555) and district (n = 107) levels, meaning that settlements located further from their nearest market also tend to experience poorer road connectivity and access to the subdistrict economic hub. Clustered in northern Bihar and coastal Odisha, approximately 18.5-million people live in districts which are relatively climate vulnerable, and simultaneously, where market inaccessibility is relatively high and multidimensional. This analysis also uncovers tentative evidence of food system inequalities, with hotspots of coexisting vulnerabilities disproportionately populated by “Schedule Caste and Schedule Tribe” (SC/ST) communities. The identification of coexisting vulnerability hotspots has important implications for the development of equitable and resilient market systems that bolster access to nutrient-dense foods amongst relatively climate vulnerable and nutritionally insecure populations.