ABSTRACT: Severe poverty is a major global problem about risk and inequality. What, if any, is the relationship between equality, fairness and responsibility in an unequal world? I argue for four conclusions. The first is the moral urgency of severe poverty. We have too many global neighbours that exist in a state of emergency and whose suffering is intolerable. The second is that severe poverty is a problem concerning global injustice that is relevant, but not restricted, to questions about responsibility. If none were responsible, this does not eliminate all compelling claims to provide assistance. The third is that severe poverty represents an inequality too far; it is a condition of extremity with denial of basic needs. The fourth is that there is a need for an approach that captures all relevant cases – and the capabilities approach and the connection theory of remedial responsibilities are highlighted as having special promise.