This paper assesses adaptation in the freshwater sector to derive lessons on what motivated societies to change, which factors led to more successful adaptation, and how interventions may best be sustained. We compared the lessons derived from three portfolios adaptation research projects, namely the WWF - ANU assessment of six developing country cases, Institute for Social & Environmental Transition (ISET) in South Asia and START’s adaptation research program Assessments of Impacts and Adaptations to Climate Change (AIACC) globally. The key conclusions for more effective climate change adaptation are that: 1. Robust adaptation interventions that reduce key risks should commence now despite uncertainties as to the precise magnitude of climate impacts; 2. Sustainable development and adaptation measures can be compatible; 3. Adaptation should be mainstreamed, not implemented separately; 4. Strengthening key institutions, knowledge sharing, and building human resource capacities are crucial to effective adaptation; 5. Adaptation strategies are strengthened by: community ownership and subsidiarity; concurrent and linked action at different geopolitical scales and in different sectors; consistent funding; and long term, iterative programs; 6. National governments can best help by facilitating climate risk communication and knowledge sharing opportunities for adaptation; building adaptive management into their institutions and policies, mandating and supporting sub-national institutions; removing barriers to funding sub-national institutions; and allocating funding for adaptation.