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This paper examines tensions between the MAS government’s recent implementation of Food Sovereignty (FS) policies and the pressure to increase development based on an agro-industrial model. The Bolivian state’s incorporation of the FS concept with Food Security policies has implications for small farmers that raises questions regarding the concept’s limitations once it is adapted to serve state purposes. Contradictions between FS as it is envisioned by the global peasant social movement, La Vía Campesina, and the way it is utilized by the Bolivian government present challenges to collaboration efforts between local social movement actors, small farmers and state actors. Importantly, related contradictions emerge between certain ideals of a Plurinational state and (neoliberal) economic policy. This paper scrutinizes FS policy implementations through a gendered lens, shedding light on the extent to which patriarchal structures of the state have been overcome or remain entrenched. The tension between policy and practice in gender equality exposes a persistent struggle for women’s secure access to farmable land and food security. As indigenous women’s organizations take up FS as a tenet, they work toward reshaping gender relations at the grassroots and state levels, with implications for food security & sovereignty policies within Latin America more broadly.