Changes in climate, associated hazards, local adaptations in agriculture, and socioeconomic factors affecting adaptation were investigated using data from a large survey of 2310 households (HHs) in the Koshi River Basin (KRB), Nepal. More than 80% of HHs had perceived changes in climate in the 10 years preceding the survey, and 20–40% had perceived increases in the occurrence of droughts, dry spells, floods, and livestock diseases.