Five case studies were carried out between June 2008 and September 2009 (in Chitral District, Pakistan; the Koshi basin, Nepal; Bihar, India; Assam, India; and Yunnan province, China) to document adaptation strategies at local or community level to constraints and hazards related to water and induced by climate change in the Himalayan region. The study teams looked at how people are affected by water stress and hazards, their local short and long-term responses, and the extent to which these strategies reduce vulnerability to water stress and hazards. The results are summarised in this synthesis document, which is accompanied by a CD-ROM with reports of the separate case studies.