This report details a three-year project managed by five participating countries: Bangladesh, Pakistan, Nepal, India and the USA. The project focused on the following activities: • analysing recent experience in climate variability and extreme hydrological events, and their impacts on regional water resources • assessing the impacts of projected climate change and variability and associated extreme hydrological events, and socio-economic changes on the water resources of Pakistan, India, Nepal, and Bangladesh • determining the vulnerability of regional water resources to climate change, and identifying key risks to each sub-region and prioritising adaptation responses • evaluating the efficacy of various adaptation strategies or coping mechanisms that may reduce vulnerability of the regional water resources • providing inputs to relevant national and regional long-term development strategies