The protracted humanitarian crisis in Northeast Nigeria has created complex challenges for communities in conflict-affected areas such as Mafa Local Government Area (LGA) in Borno State. While humanitarian food aid is essential for survival, it can unintentionally exacerbate tensions and conflict within vulnerable communities. This study explores the dynamics of conflict associated with the provision of humanitarian food aid in Mafa through a qualitative exploratory design. Findings reveal that conflict arises from a combination of contextual factors such as resource scarcity, unmet needs, and lack of livelihood opportunities and operational factors such as inadequate communication, unclear selection criteria, and perceived exclusion. The study concludes that an encompassing, conflict-sensitive approach of established accountability that integrates humanitarian assistance with resilience-building and participatory processes is critical for mitigating aid-related tensions. Recommendations include enhancing accountability mechanisms, promoting sustainable livelihoods, and fostering collaboration between humanitarian actors and government agencies. This research contributes to the discourse on conflict-sensitive humanitarian programming and offers practical insights for designing interventions that uphold the principle of “do no harm” in fragile contexts.