Agrifood systems extend beyond the farm, yet the midstream and downstream—the “hidden middle”—remain under-researched. This paper reviews 276 studies on policies for the hidden middle in low- and middle-income countries. While 52% focus on smallholders and 21% on public goods, only 27% address the hidden middle. Nearly half concern contract farming, designed to bypass intermediaries rather than strengthen them. Most midstream categories rely on fewer than four rigorous studies. Moreover, services like storage are evaluated mainly for producers, ignoring the MSMEs dominating the hidden middle. Addressing this gap is critical for inclusive systems, requiring a focus on actors connecting farms to consumers.