Existing documentation establishes evidence that the Hindu Kush Himalayan region is vulnerable to climatic and weather variability, and to extreme events whose adverse impacts are already being observed. The climatic and weather related events create stresses that add to the multiple non-climate stressors that the region experiences. The latter include chronic and transient poverty, high levels of migration, inadequate provision of basic amenities and health care, high density of population and the region’s dependence on natural resource based livelihoods such as agriculture, forestry and allied activities. Under these circumstances, it is important to put in place appropriate adaptation responses that build resilience and can reduce risks associated with a changing climate. Adaptation responses can follow multiple pathways to address the large gaps in achieving threshold levels of the quality of life, and the new risks posed by climate change.