A warm and adequately-lit home is considered a basic need, together with access to energy-consuming appliances ranging from a fridge to a TV. An underlying tenet of sustainable energy is that such basic needs should be affordably met. Yet low incomes, energy-inefficient housing and appliances and high energy costs mean that roughly 10 per cent of UK households, many of them elderly or with young children, fail to attain this basic standard. These households, which would need to spend more than 10 per cent of their income to attain adequate energy services, are officially defined as 'fuel poor'. Their cold, poorly equipped homes lead to chronic cold-related health conditions, exacerbate social isolation, and may undermine educational achievement. in addition, rural areas have a disproportionately high incidence of fuel poverty. This Review examines the current distribution of energy consumption, its social impacts, and the opportunities to address fuel poverty through improvements to the housing stock. It will then consider potential future developments. (c) 2008 Queen's Printer and Controller of HMSO. Published by Elsevier Ltd. All rights reserved.