Fruits and vegetables are vital for healthy diets, but intake remains low for a majority of the global population. This paper reviews academic literature on food system issues, and opportunities for research and action, as an input into the 2021 UN Food Systems Summit in the context of the International Year of Fruits and Vegetables. The paper summarises evidence underpinning food system actions to make fruits and vegetables more available, accessible and desirable through push (production and supply), pull (demand and activism) and policy (legislation and governance) mechanisms, with action options at macro (global and national) meso (institutional, city and community) and micro (household and individual) levels. It also suggests the need to recognise and address power disparities across food systems; and trade-offs among diet, livelihood and environmental food system outcomes. We conclude that there is still a need to better understand the different ways that food systems can make fruits and vegetables available, affordable, accessible and desirable across places and over time – but that we know enough to accelerate action in support of fruit- and vegetable-rich food systems driving healthy diets for all.