Ready-to-use therapeutic foods (RUTFs) are special foods used to encourage rapid weight gain in 5-year-old malnourished children, avoiding hospitalization. The factors affecting sensory characteristics and acceptability of RUTFs have been not adequately described. The aim of this work was to evaluate both the sensory properties and volatile compounds of four alternative RUTFs, varying in soy and sorghum, icing sugar, and oil content. Nine nonoral sensory attributes were evaluated by nine selected and trained assessors. The perceived intensity of five oral sensory attributes and the overall liking were assessed by 100 adult consumers. The volatile compounds were extracted and concentrated by solid phase microextraction and analyzed by gas chromatography/mass spectrometry. RUTF formulations significantly differed for graininess between fingers (size of granules) (P = 0.007), viscosity (P = 0.013), adhesiveness to the spoon (P < 0.044), and meltability (P = 0.005), but in consumers' opinion, they differed only for difficulty in swallowing, intensity of global odor, flavor, and sweetness. A positive correlation between overall liking and sweetness was found. Volatile compounds arising from lipid oxidation (hexanal and octanoic acid) were positively correlated with global odor and flavor. These attributes negatively affected the overall liking and were mainly contained in one out of the four formulations. Sensory and instrumental characterization identified key attributes for this kind of food, such as difficulty in swallowing, global odor, and sweetness, suggesting how to formulate an alternative RUTF to be used for a future clinical trial on malnourished children. PRACTICAL APPLICATION: Starting from the world's need to fight child malnutrition, the present study tried to characterize alternative ready-to-use therapeutic foods (RUTFs), special foods used to encourage rapid weight gain in 5-year-old malnourished children, from several points of view, such as acceptability, stability, technological, and overall quality. Results obtained will be an aid to setup the technological conditions and scale-up parameters for local productions of RUTFs to be tested in real trials on malnourished children. Indeed, key sensory attributes that drive consumer acceptance for this special food, such as sweetness and difficulty in swallowing, came out from the present study.