Although the exact burden of foodborne disease is unknown, diarrheal diseases kill approximately 2.2 million people annually. Even in developed countries foodborne illness is estimated to affect over 20% of the population annually. During natural disasters existing food safety and security measures may be damaged and mission priorities during emergencies may prevent inspection agencies from conducting normal inspections and enforcing government regulations. This breakdown in the food safety infrastructure may lead to increases in foodborne diseases within the local population and relief workers. The risk in this latter group is possibly magnified by their immunologic naïveness to local pathogens and an outbreak among relief workers can severely impact support operations, interfere with the aid delivery, and may result in the loss of life. In addition to natural disease transmission, there is the potential for terrorist organizations to target relief workers through deliberate contamination of the food and water supplies. Consequently, relief agencies should consider both food safety and security during disaster operations. A Food and Water Risk Assessment (FWRA) is a tool for identifying potential high risk food items and practices in local food sources and facilities and examines the overall food operation, the food facilities and equipment, water potability, cleaning and sanitation, pest control, employee health and sanitation, food security, and the source of the food items. The FWRA identifies risk items and provides mitigative control measures designed to reduce the residual risk to acceptable levels and minimize potential disruption of mission operations. Although the ultimate goal is protecting the health of the relief workers, the FWRA can also be used as a tool to improve the food safety practices of local food facilities and suppliers which will in turn help to reduce the incidence of foodborne disease among the local population during the disaster relief operations and beyond.