UNEP recognizes the importance of the Nile River Basin in the context of a variable and changing climate and hence the imperative to design and pilot adaptation options at basin level. The objective of this report was to identify and evaluate best practice adaption options in response to risk, and vulnerability to climate change induced water stress as well as in the context of stated national adaptation priorities and climate change response strategies. This report contributes to the goal of building the resilience of ecosystems and economies that are most vulnerable to climate change induced water stress in the Nile Basin. The adaptation best practice examples presented in this report provide an evidence-base upon which the project on ‘Adapting to Climate Change induced Water Stress in the Nile River Basin’ can increase institutional and technical capacity to further test, replicate and scale up at the Nile River Basin level.