Small fish are a common food and an integral part of the everyday carbohydraterich diets of many population groups in poor countries. These populations also suffer from undernutrition, including micronutrient deficiencies – the hidden hunger. Small fish species, as well as the little oil, vegetables and spices with which they are cooked enhance diet diversity. Small fish are a rich source of animal protein, essential fatty acids, vitamins and minerals. Studies in rural Bangladesh and Cambodia showed that small fish made up 50–80 percent of total fish intake in the peak fish production season. Although consumed in small quantities, the frequency of small fish intake was high. As many small fish species are eaten whole; with head, viscera and bones, they are particularly rich in bioavailable calcium, and some are also rich in vitamin A, iron and zinc. A traditional daily meal of rice and sour soup, made with the iron-rich fish, “trey changwa plieng” (Mekong flying barb, Esomus longimanus), with the head intact can meet 45 percent of the daily iron requirement of a Cambodian woman. Small fish are a preferred food, supplying multiple essential nutrients and with positive perceptions for nutrition, health and well-being. Thus, in areas with fisheries resources and habitual fish intake, there is good scope to include micronutrient-rich small fish in agricultural policy and programmes, thereby increasing intakes which can lead to improved nutrition and health. The results of many studies and field trials conducted in Bangladesh with carps and small fish species have shown that the presence of native fish in pond polyculture and the stocking of the vitamin A-rich small fish, “mola” (mola carplet, Amblypharyngodon mola), did not decrease the total production of carps; however, the nutritional quality of the total fish production improved greatly. In addition, mola breeds in the pond, and partial, frequent harvesting of small quantities is practiced, favouring home consumption. A production of only 10 kg/pond/year of mola in the estimated four million small, seasonal ponds in Bangladesh can meet the annual recommended intake of six million children. Successful aquaculture trials with polyculture of small and large fish species have also been conducted in rice fields and wetlands. Thus, aquaculture has a large, untapped potential to combat hidden hunger. To make full use of this potential, further data on nutrient bioavailability, intra-household seasonal consumption, nutrient analyses, cleaning, processing and cooking methods of small fish species are needed. Advocacy, awareness and nutrition education on the role small fish can play in increasing diet diversity and micronutrient intakes must be strengthened. Measures to develop and implement sustainable, lowcost technologies for the management, conservation, production, preservation, availability and accessibility of small fish must be undertaken. Also, an analysis of the cost-effectiveness of micronutrient-rich small fish species in combating micronutrient deficiencies using the Disability-Adjusted Life Years (DALYs) framework should be carried out.