This publication presents the results and lessons learned from the FAO-Sida supported pilot project "Strengthening capacity for climate change adaptation in land and water management" in Ethiopia, Kenya and Tanzania. The project proposed an integrated package of approaches that addressed the drivers of vulnerability and targeted climate change impacts. It focused on technologies that improve soil health and facilitate water conservation, the diversification of the sources of livelihood and income, and the strengthening of local institutions. The publication describes a series of pilot activities that successfully contributed to enhanced resilience of farming communities and offer substantial opportunities for upscaling. This experience shows that a boost in investment is needed to ensure a more sustainable and resilient management of an already declining resource base, and that adapting to climate change in the region will require renewed efforts in improving land and water management through supportive policies, capacity development and targeted investments.