As a growing proportion of world’s population lives in cities and towns, food security is increasingly acquiring an urban character. The locus of food security research and policy agendas has correspondingly expanded from rural areas to include cities and towns in the past few years. However, the dominant discourse on urbanization-food security relationship appears to be shaped by perspectives from the Global North and large cities, and shows a lack of adequate understanding of the urbanization-food security nexus in the small towns of the Global South. This paper aims to correct this bias. With a focus on India where urban growth is increasingly concentrated in small, former rural regions, this paper reviews the food and nutrition security implications of the country’s rural-urban transition. It identifies three conceptual pathways through which to understand the bearing of rural-urban transition on food and nutrition security that include: livelihood change, land use change, and dietary change. The evidence reviewed suggests the overall worsening of food and nutrition security for people in this rural-urban transition, particularly for the poor populations. The paper also identifies several key research questions and calls for more research on the urbanization-food security nexus in India.