This report provides an account of the evolution of poverty and living conditions in the decade 2012- 2022. It finds that at the national level monetary poverty essentially stagnated while urban poverty, admittedly a much smaller in absolute and relative terms, dramatically increased. In 2022, monetary poverty affected about 75 percent of the population, a share slightly above the 73 percent in 2012. Rural poverty remained roughly unchanged at about 80 percent of the rural population, but urban poverty increased from 42 to 56 percent over the decade. The increase in poverty was especially dramatic in secondary cities, where poverty increased from 46 to 61 percent (chapter 1). A closer look at the drivers of poverty reveals that the trends of the last decade are explained by market and governance failures, climatic shocks and the COVID pandemic. Structurally, stubbornly high rural poverty is the legacy of long-term infrastructure underinvestment, isolation, and low internal demand (World Bank Group, 2022). But since 2013, this structural failure to launch has also affected urban employment and living conditions as private investment has persistently declined and competition was suffocated by special interests. Moreover, the COVID pandemic, which caused an exceedingly long border closure and wiped out tourism revenues until mid-2022, and a repeated string of cyclones wreaked havoc on the service economy, destroying as many as a quarter of jobs and slashing urban incomes (chapter 3). About three-quarters of the population suffers from food insecurity, and this share has remained broadly unchanged for a decade or more. Most households, especially in rural areas, lack access to reliable electricity, safe water, or adequate sanitation. Access to healthcare is inadequate while high fertility, teenage pregnancy (about one-third of girls 15-19 is a mother already) and low education completion (only about half of all children complete primary school) erode future human capital (chapter 4). Climate resilience is a cross-cutting challenge. Madagascar is highly vulnerable to extreme weather events such as tropical cyclones, heavy rains, droughts, and heatwaves (chapter 5).