The Hindu Kush Himalaya is undergoing rapid change, driven by twin megatrends of climate change and urbanisation, which threaten their crucial water-provisioning services for over a billion people across Asia and undermine quality of life, economic development, and environmental sustainability within the region. This chapter examines current and future megatrends Megatrendsfrom a mountain perspective, assessing the impacts for water, energy and Foodsecurityfood security Food securityof glacial meltGlacial melt, altered river flowsRiver flows and drying springsDrying springs, coupled with unplanned urban growth Urban growthand outmigration. Further innovation Innovation is needed in responding to climate-induced risk, developing hydro-power sustainably and enhancing mountain agriculture.Mountain agriculture