Severe Acute Malnutrition (SAM) is the most severe form of malnutrition which is highly linked to mortality and morbidity in children under 5. India has the largest burden of severe malnutrition in the world, with 9.3 million under the age of five affected by SAM. Current nutrition protocols in India for addressing SAM do not meet international recommendations and rely more on preventive strategies and an inpatient model of care. Lack of awareness, cultural beliefs and practices, and inadequate access to healthcare also attribute to the high prevalence of SAM. Using the knowledge from the previous interventions in India, MSF started a pilot Community Management of Acute Malnutrition (CMAM) project in June 2017 in Chakradharpur block of Jharkhand, which is one of the most vulnerable and high burden states in India. The project aims to demonstrate evidence around a community-based approach and decentralized delivery of care that can influence national protocols and policies on the treatment of SAM and has successfully treated over 600 children till date.