This paper explores the rationale behind small store interventions by pulling together various studies in health, planning, and marketing literature and pilot work conducted in New Orleans. The authors discuss store and food availability in lower-income neighborhoods and how changing the foods available in stores can affect purchasing behavior, diet and the economics of local small food stores. Initiatives in New Orleans and elsewhere have demonstrated success with improving healthy food availability. However, the efforts to encourage small store operators to offer healthier foods may depend on the profitability of such changes.