Twenty million people in Central Americacook with biomass using open fires or rudimentary stoves.The number of people using biomass for cooking in the regionwill remain significant for a long time due to highincidence of poverty, high Liquid Petroleum Gas (LPG) pricescoupled with unsustainable LPG subsidies, as well asrelatively easy access to fuel wood in the region. Providingthese people with clean and efficient cooking solutions isnot just an energy issue, but one related to poverty, genderinequality, public health, environmental sustainability,local employment, climate change, agriculture, and localemployment. A new generation of improved biomass cook stoves(ICS) has recently become available in Central America. Theeconomic benefits from improving public health, reducingdeforestation, and mitigating greenhouse gas emissions welloutweigh the costs of ICS dissemination. Efforts involvingdonor agencies, governments, non-governmental organizations,as well as local entrepreneurs have been made to disseminateICS in the region in the last 10 years. The objective ofthis study is to better understand current developments inclean and efficient biomass cooking solutions, factors thathave precluded a larger penetration of ICS within theregion, and lessons learned from past programs-both in theregion and in other countries-that may be relevant toCentral America. The study recommends key actions that mayhelp the region step up its current dissemination effortsand promote sustained use of ICS, a first step towarduniversal access to ICS by fuel wood users. Its intendedaudience includes different stakeholders, includinggovernment agencies, regional and internationalorganizations, as well as various implementing entities whoare thinking or rethinking appropriate technologies, policyinterventions, financing, and delivery mechanisms forCentral America to promote ICS.