This paper presents the results of a systematic qualitative Cost-Benefit Analysis of embankment construction in the lower Bagmati River basin in Nepal and India. Using a unique Shared Learning Dialogue (SLD)-based qualitative cost-benefit that also begins to quantify impacts, it provides insights into the trade-offs among strategies that are similar to, but more transparent than, those used in a full cost-benefit analysis. Additionally, it reveals the costs and benefits for different sections of the populations as opposed to just the society as a whole (which is typically the focus of traditional CBA). The focus of the qualitative CBA is to analyze the costs and benefits of both structural flood control measures, and a wide array of local, “people-centered” strategies. It shows that many of the current structural measures costs have exceeded their benefits and as a result, especially under the increasing uncertainty of climate change, more people-centric, flexible solutions will likely be more resilient.