The Central Asian region is particularly vulnerable to the effects of climate change, which will exacerbate an already difficult situation characterized by low rainfall, aridity, severe weather fluctuations and uneven distribution of resources. Measures for adaptation to climate change are included in the complex of preventive / preparatory / response measures to combat the negative effects of climate change. Such measures are aimed not only at mitigating the negative impact, but also at maximizing the use of existing opportunities. The fact is that adaptation measures (in addition to other development priorities) are, in fact, very costly: hence the lack of funding. In addition, there is a lack of local experience with climate change modeling and conflicting models and forecasting methods that are then difficult to use to build comparative data. We should not disregard the fact that traditionally the accuracy of predicting climate change is not high. Despite the differences in situations in the five countries of the region, two critical priorities for adaptation measures are relevant for the entire region. These priorities were water and agriculture. Based on the results of the analysis , it was concluded that over the past few years, the region has made significant progress in the field of adaptation-identified high-risk areas, proposed adaptation measures, drafted national adaptation plans and, finally, formed a small fund of best practices in the field of application of adaptation measures. Further activities are proposed to be concentrated in the following areas: 1) improving the quality of the proposed measures (eliminating inconsistencies between the required and proposed measures) and 2) promoting the implementation of adaptation measures (eliminating inconsistencies between the proposed and actually implemented local measures). Beyond the water and agriculture sectors, there is a need for more research and policy action in the health, forestry and biodiversity sectors.