In Nepal, international migration is a highly gendered phenomenon. Compared to global figures, where women make up about half of the world’s migrant population, 90% of Nepalese migrants are men. Many of these men migrate alone to earn wages abroad while their families stay behind. This level of male out-migration in Nepal occurs in a context characterized by widespread food insecurity. This paper examines the effects of male out-migration on household food security, especially on the women who stay behind, in the mountains of Far West Nepal. Our findings from in-depth interviews and focus group discussions suggest that male out-migration both alleviates and exacerbates households’ experiences of insufficient quantity and inadequate quality of food, and uncertainty and worry about food. Migration can benefit households that stay behind through remittances which help cover basic expenses, and by facilitating access to loans and credit, and alleviating anxiety about having enough to eat. However, it comes at high costs. Men report undignified, unsafe, and difficult working conditions in India. Women bear additional childcare, fieldwork, and housework responsibilities. Limited male agricultural labor also hampers agricultural productivity and increases households’ reliance on markets to meet basic needs. Drawing on gender- and caste-specific findings, our study highlights the importance of looking beyond the financial aspects of migration when examining its effects on food security.