Systemic violence refers to the harm people suffer from the social structure and the institutions sustaining and reproducing it. This type of violence prevents its victims from satisfying their basic needs, and is an avoidable impairment of the fundamental means necessary for human existence. This chapter explores how social, economic and political arrangements cause systemic violence, how such arrangements are presented as ineluctable outcomes of human interactions and historical processes, and how they are supported by justificatory ideologies. From the perspective adopted in this chapter, systemic violence manifests itself in higher rates of disability and death suffered by certain social groups, and in the constraints imposed on them that limit their ability to change their condition. But limitations also hamper, in a general sense, the achievement of the quality of life that should be guaranteed to everyone, and pertain to the spheres of politics, the economy, culture or the law. The chapter argues that these limitations not only imply a condition of injustice and oppression, but also contain a violent core determined by human decisions rather than by nature.