The Mountains of the Hindu Kush Himalaya (HKH) region are known as water towers or the Third Pole as they bear more ice and snow than any other region outside the Poles (Dyhrenfurth 1955; Qiu 2008). They are one of the most vulnerable regions from a climate change perspective. Mountains are considered reliable indicators of global warming and provide an opportunity to better understand climate change impacts despite inadequate information. This chapter focuses on the mountain systems of the HKH region to better understand climate change impacts and vulnerability. It takes the case of Nepal, a mountainous country of the Himalayas, to discuss adaptation needs, and draws on key learning for a mountain-specific adaptation strategy. The chapter analyses government policies and programmes and climate initiatives to illustrate policy responses and effectiveness of adaptation to climate change.