Ecosystem-based Adaptation (EbA) has been gaining attention in science, policy and practice as an effective way to address climate change and contribute to sustainable development. In Hindu Kush Himalaya (HKH), EbAs are implemented to enhance resilience of mountain communities to the harsh realities of climate change. However, very little documentation exists on nature and progress of EbA in the region, which are often fragmented and scattered. We analyzed the status, progress, benefits and challenges in EbA implementation. EbAs are focused on restoration (17%), mainstreaming in policy and plans (17%), ecosystem conservation (14%), flood risk management (12%), livelihoods (10%), capacity building (10%) and ecological risks assessment (7%). Though EbA varies across the countries, ecosystem conservation and livelihoods diversification is the focus. Major drivers of changes considered are climate change, floods, drought and landslides. Improved resilience through restoration, capacity building, better networking and better wellbeing are some of the notable benefits. However, awareness and mainstreaming of EbA in policies and plans are limited. Limited cooperation among the countries and stakeholders and short-lived donor-driven agendas are also the challenges. An effective and impactful EbA requires an integrated approach encompassing different sectors with vertical and horizontal cooperation and collaboration at the regional scale.