In this case study, the costs and benefits under potential climate change of different flood risk reduction approaches in northern India were analyzed and compared. In addition, the utility, applicability and limitations of cost-benefit analysis for supporting disaster risk reduction decision-making under a changing climate were investigated. Beginning with a risk analysis, past flood impacts were adapted to current conditions and then projected for future changes in risk due to climate and population changes. Flood risk reduction strategies were selected based on both real and potential interventions. Field experience and estimations were used to quantify and monetize costs, benefits and disbenefits (potential negative consequences of interventions), which were subsequently compared under a probabilistic cost-benefit framework. Finally the methodology, experiences and results of the analysis process were reviewed for robustness and utility within the policy context.