Angola, Burundi, Congo Republic, the Democratic Republic of the Congo (DRC), Eritrea, Ethiopia, Guinea-Bissau, Kenya, Liberia, Mauritania, Rwanda, Sierra Leone, Somalia, Sudan, Tanzania and Uganda are all in dire need, says the agency.
(Click here to see a map of the region)
Burkina Faso, Gambia, Niger, Senegal and Zambia, which were on the agency's 1998 list of 18 emergency-hit states, were missing this year, replaced by Congo Republic, Kenya and Tanzania.
In east Africa, the food supply has deteriorated, says the report which names Somalia as particularly grim because of bad weather, the long-running civil war and uncontrolled crop pests and diseases.
It says close to half a million people there are at risk of starvation.
In Ethiopia, five million people are facing a shortage due to drought.
Angolan war
In southern Africa, the report highlights the devastation to crops caused by the thousands of Angolans who have been forced to flee the civil war.
But the FAO reports on one bright spot - west Africa, where crop prospects this year are favourable, notably in sub-Saharan Africa.
Southern Sudan enjoyed favourable harvest conditions but persistent civil conflict meant the food situation continued to be difficult.
Conflict was also taking its toll in the Great Lakes region. The food supply situation in the Democratic Republic of Congo remained precarious thanks to insecurity and migration, while renewed fighting had worsened food shortages.