Himalayan communities live in marginal environments. They are dependent on ecosystem services and thus highly exposed to climate variability and change. This study aimed to help understand how mountain communities perceive change, how change impacts their livelihoods, and how they respond to change. Forty focus group discussions and 144 in-depth interviews at the household level were conducted in 20 villages in northwest India and across Nepal. Perceptions of change were compared with actual climate records where available. Respondents considered rainfall patterns to be less predictable and had experienced an overall reduction in water availability, severely affecting their harvests. Increased temperatures were also reported, particularly at higher elevations. People responded to the changing conditions with a wide range of coping and adaptation mechanisms. However, many of these mechanisms will not be sustainable in view of the likely magnitude of future climate change, and they are also restricted to social groups with appropriate assets. The poor, lower caste families, women, and other marginalized groups are particularly vulnerable and less able to adapt. Targeted efforts are required to move from coping to adapting and to avoid inequalities between social groups increasing due to the different adaptive capacities.