The average time that the ICRC has been present in its 10 largest operations is 42 years. The duration of humanitarian operations in protracted conflict settings has caused organizations like the ICRC to re-think their way of working. The humanitarian consequences of protracted situations of armed conflict are varied, including the cumulative effects of hostilities on infrastructure and healthcare systems, prolonged displacement, increased barriers to accessing essential services to provide support for vulnerable groups including persons with disabilities, and interruptions to education to name just a few. In light of the humanitarian imperative to respond to these needs in spite of the ouroboros of a seemingly endless war, the Review has dedicated this edition to protracted conflict.