Women are the primary food providers within Cambodian families, however little is known about what influences their food choices. Despite recent economic improvements, Cambodia remains the second poorest country in south-east Asia(1). Twenty-two percent of Cambodian children have stunting and 16% are underweight(2). Cambodian women of reproductive age exhibit the double burden of malnutrition, with 44% having anaemia and 33% with overweight or obesity(2). Nearly half of Cambodian women do not achieve minimum dietary diversity, with diets consistently low in vitamin A, thiamine, calcium, zinc and iron(3). Strategies to improve Cambodian families’ dietary intake are therefore needed. Factors influencing food choice are complex and multidimensional(4), and no previous studies have explored how Cambodian women make food decisions. This study aimed to understand Cambodian women’s food-related decision-making for themselves and their families. This qualitative study applied a descriptive methodology consistent with the experiential paradigm. Four 90-minute focus groups were conducted in rural and urban locations of Siem Reap province, Cambodia. Participants were Cambodian women aged 18+ years with at least one child aged under five who have primary responsibility for food provision within their family. Focus groups were facilitated by an Australian researcher (JW), using an interpreter to translate between Khmer and English languages. Groups discussed perceptions about food related to health, prompted by ‘conversation cards’ depicting food sources and nutritional benefits of five key nutrients. Reflexive thematic analysis was used to analyse the focus group data(5). Three themes were identified: 1) food access impacts choice; 2) responsible nurturing food provision role; and 3) dichotomous perceptions of food. Access to food strongly influenced food choices made by Cambodian women. High cost and low availability prompted women to forage for easily accessible ingredients such as water plants, fish, crabs and fruit, or choose cheaper, lower-quality foods from the market. Cambodian women strived to fulfil their responsibility to provide healthy, nourishing meals for their family within their capabilities, prioritising their husband and children over themselves. Nutritional awareness included understanding that fruit and vegetables contained vitamins, and meat was a good source of iron. They perceived certain traditional Khmer soups as ideal healthy meals, providing adequate energy and strength for hard-working husbands and growing children, and preventing sickness. Cambodian women considered healthy food using a range of dichotomous factors beyond their nutritional value, including ‘wet or dry’ food, ‘helpful or harmful’ in relation to immediate body symptom responses to food, cultural food taboos and use of chemicals on fresh vegetables. These findings indicate the need for future nutrition interventions targeting Cambodian communities to address women’s perceptions about the health-related qualities of foods, and access to nutritious foods so that behaviour change strategies are practical, culturally appropriate and acceptable.