Climate change and variability exerts multiple stresses at different spatial and temporal scales on the biophysical as well as the social-economic and institutional environments in Kilimanjaro transect in Tanzania. The primary stresses include climate risks such as drought and flood, which in turn trigger secondary stresses such as the spread of water borne diseases, increased competition for resources, disruption of ecosystem services, habitat and biodiversity losses. This paper presents the key findings of the study which investigated the impacts of climate change on socio-economic activities and existing local adaptation strategies. The study was undertaken across the Kilimanjaro transect located in Pangani river basin upstream of Nyumba ya Mungu dam in Tanzania. The study area was sub-divided into three agro ecological zones namely: lower, middle and upper zone. Three villages were sampled purposively one from each zone in order to capture various economic activities requiring water as an input for development. Both quantitative and qualitative methods were used for data analysis. The study shows that, traditional surface irrigation (flooding) methods is the most common adaptation strategy for crop production and account for more than 79% of the total irrigation schemes in the study area. However, traditional irrigation schemes are characterized by poorly constructed and temporary infrastructures that are usually associated with significant water losses and low crop productivity. Therefore, promotion of efficient irrigation water use through research and adoption of good farming practices is, critical to ensuring sustainable use and management of the water resources for sustaining water availability for other socio-economic sectors. This study recommends application of Ecosystembased Adaptation (EBA) approach that integrates the use of biodiversity and ecosystem services into climate change adaptation strategies.