In recent decades, small-scale farmers’ market orientation approaches have increasingly been adopted to tackle the problem of food insecurity. However, little is known about how this affects other non-market exchange relationships. The present paper addresses this knowledge gap using qualitative data gathered from small-scale farmers at three selected sites in northern Ethiopia. We took a social exchange theory perspective to examine how resource exchanges have altered after-market orientations in rural communities. The results indicate that, in addition to the benefits for better-off households, integration into the market economy improves the bargaining power and autonomy of middle-income groups as well as the physically fit younger generations. The results also suggest that market orientation generates new livelihood opportunities and market-based relationships, which in turn facilitate the formalisation and transformation of local institutions. On the other hand, market orientation has adverse impacts on traditional practices of resource exchange – such as labour for labour, oxen for labour, labour for harvest/yield, or labour for food – or the exchange of other services. Our results indicate that because these in-kind resource exchange relationships have been replaced by monetary transactions, the poor have become even more vulnerable. The policy implication is that while promoting market-driven approaches to food security, complementary mechanisms must be put in place to empower those living in the most vulnerable conditions.