United Nations data says that an estimated 4.2 lakh people around the world die every year after eating contaminated food, and children under 5 years of age carry 40% of the food-borne disease burden, with 1.25 deaths every year. Yet, the sufficiency of food through production and distribution overshadows the requirement that food be safe, even though both are critical to ensuring food security. Strong surveillance against contamination and adulteration of food along the value chain from production to distribution to the end consumer is needed, but enforcement of food safety norms gets the least priority. A nexus of unscrupulous traders and corrupt food safety officials takes advantage of the poor awareness level of people about food safety and dilutes the safety standards across the country. The detection of formalin in fish and harmful chemicals in artificially ripened fruits and vegetables in Assam has exposed unethical marketing strategies and how such contaminated and adulterated food is posing health hazards to people in the state. The issue of formalin in fish came to the fore following the publication of research findings from a college. Food safety inspectors failure to detect the presence of formalin in fish procured by traders from outside the state and sold in local markets points towards food surveillance being ineffective and lacking oversight mechanisms to enforce the safety standards. Similarly, the Gauhati High Court ordered testing of samples for the presence of harmful chemicals in fruits and vegetables before the supplies enter wholesale markets in Guwahati after a Public Interest Litigation was filed, which also revealed that food safety surveillance in the state has wide gaps due to which contaminated vegetables escaped detection and continued to be sold in the markets, posing grave health risks to consumers. The High Court has urged the Assam Food Safety Commissioner to extend their jurisdiction to agricultural fields for the detection of contamination of agricultural produce and take necessary action. The state’s having adequate food safety inspectors will be critical to ensuring that surveillance covers all districts and that no agricultural produce with harmful chemicals goes undetected. Strong punitive measures against food contamination will have deterrent effects. The Food Safety and Standards Authority of India (FSSAI) has announced its decision to conduct nationwide surveillance on milk and milk products as part of its effort to curb adulteration of milk and milk products. This pan-India surveillance will be carried out on a large scale by collecting samples from both the organised and unorganised sectors in all states and union territories, as the apex food regulator stated in an official release. A Pan-India Surveillance on Jaggery conducted by FSSAI in 2022 to assess the safety and quality issues and identify the hot spots of adulteration across the country brought to light that 34.5% of samples were “substandard”, 5.5% were misbranded, and 1.8% were both substandard and misbranded. The FSSAI grouped samples that showed non-compliance with the specified limits for chemical quality parameters as “substandard” samples and those that did not meet the requirements of FSS labelling, advertising, and claims regulation as “misbranded”. Given the size of food producers, food traders surveillance by food safety inspectors alone cannot stop contamination and adulteration of food items. If awareness is also built among consumers to distinguish adulterated food products from safe ones, then they will start rejecting such contaminated food, which will have a huge impact on bringing down demand for such unsafe food. It will not be possible for consumers to detect the presence of harmful substances, but the appearance of fruits and vegetables that are grown using permissible limits of inorganic chemicals and those grown oversize or lacking natural colour due to the use of higher quantities of chemical nutrients or colouring substances differ, and keeping this fact in mind at the time of purchasing food produce can reduce consumption of harmful fruits and vegetables. The safest option is to go for organic food produce, but for consumers, it is difficult to find those due to the absence of authorised labelling and certification. Ironically, agricultural practise among indigenous communities in the northeast region has traditionally been organic, but governments in the states as well as the Central Government have failed to provide certification to organic growers. Because of high demand against low supply, the prices of organic fruits and vegetables are high, which average consumers cannot afford. They are compelled to buy cheaper fruits and vegetables, whose production is boosted by growers through the use of higher amounts of chemical manures, without caring much about their harmful effects on health. The solution lies in promoting organic farming to boost production of safe foods and increasing surveillance against hazardous farming and contamination of food by strengthening food surveillance in each state in the region. Promotion of organic farming in the Northeast must go beyond rhetoric to make safe food available at an affordable cost.