This study determined the level and causes of food insecurity of 150 households, in the Eastern Cape Province of South Africa using the Household Food Insecurity Access Prevalence (HFIAP) and the Household Food Insecurity Access Scale (HFIAS). The majority (67.7 %) of the households interviewed were severely food insecure, the main cause being the abandonment of own food production. Average HFIAS for the sample was 12.41 and ranged from 0 to 27. Most households were dependent on government social grants for household food requirements rather than own food production or food purchases, using wages and remittances. Households in the study area were net purchasers of food, as is the situation in most rural households of South Africa. High levels of unemployment (97.5 %) among household heads were observed in the study areas. In times of food shortages, most households relied on borrowing from shops against future payment. Most of the food insecurity coping strategies used by the households had long-term detrimental effects. The ultimate way to improve the food security in rural South Africa is to increase per capita incomes and/or ensure that households have the resources and capacity to produce their own food through farming.