BACKGROUND:The war in Syria has left millions struggling to survive amidst violent conflict, pervasive unemployment, and food insecurity. Although international assistance funding is also at an all-time high, it is insufficient to meet the needs of conflict-affected populations, and there is increasing pressure on humanitarian stakeholders to find more efficient, effective ways to provide assistance. OBJECTIVE:To evaluate 3 different assistance programs (in-kind food commodities, food vouchers, and unrestricted vouchers) in Idleb Governorate of Syria from December 2014 and March 2015. METHODS:The evaluation used repeated survey data from beneficiary households to determine whether assistance was successful in maintaining food security at the household level. Shopkeeper surveys and program monitoring data were used to assess the impact on markets at the district/governorate levels and compare the cost-efficiency and cost-effectiveness of transfer modalities. RESULTS:Both in-kind food assistance and voucher programs showed positive effects on household food security and economic measures in Idleb; however, no intervention was successful in improving all outcomes measured. Food transfers were more likely to improve food access and food security than vouchers and unrestricted vouchers. Voucher programs were found to be more cost-efficient than in-kind food assistance, and more cost-effective for increasing household food consumption. CONCLUSION:Continuation of multiple types of transfer programs, including both in-kind assistance and vouchers, will allow humanitarian actors to remain responsive to evolving access and security considerations, local needs, and market dynamics.