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Relying on contributions from the International Movement ATD Fourth World, this book deals with questions such as:What does it mean to live in poverty, and especially in extreme poverty? How can very poor people be reached through development projects? How can we assess whether projects succeed in changing the lives of the poorest individuals? In answering these questions, the emphasis is on exploring what type of knowledge is needed to fight extreme poverty. A key argument is that apart from academic knowledge, a concerted effort is needed to listen to the knowledge of poor people themselves, as well as to the knowledge of practitioners who are engaged with them on a daily basis to fight poverty. After the introductory chapter, the text of a speech by Joseph Wresinski (founder of the International Movement ATD Fourth World) at a congress of social scientists held at UNESCO, is reproduced. The next contribution is based on comments by the International Movement ATD Fourth World on the World Bank’s World Development Report 2004 Making Services Work for Poor People. Thereafter, case studies are provided on participatory approaches to attacking extreme poverty in both developing countries (Madagascar and Tanzania, as well as Bolivia, Guatemala, and Peru) and developed countries (the United States and Belgium).