This chapter starts out with a description of the main impacts of climate change on water and the needs for adaptation. Subsequently, five different perspectives on the responses to the impacts are discussed. These perspectives include (i) a section on the need to cope with the climate change impacts, paying special attention to decision-making processes and the need for improved economics. The next perspective (ii) presents and discusses the lobbying process that raised the attention to water-related climate adaptation under the UN Framework Convention on Climate Change negotiations. The chapter continues with (iii) the need to adapt transboundary water agreements to also include climate change impacts. The chapter concludes with two regional cases: one about (iv) the need to adapt transboundary governance in the Mekong and (v) a case showing the usefulness of new tools developed to address the cost of adaptation in the Middle East and the North Africa (MENA) region. Through these different perspectives this chapter introduces the broad-ranging playing field for water security and climate change.