This chapter provides an overview of the vulnerability of coastal ecosystems to climate change with respect to their exposure, sensitivity and adaptive capacity, emphasising the uncertainties involved in attempting to predict ecological impacts. It explores potential options for managed adaptation action that aim to conserve coastal biodiversity and protect ecosystem functions, goods and services. The chapter discusses factors influencing adaptation decisions for coastal ecosystems and presents some guiding principles. Due to their position at the interface of terrestrial and marine realms, coastal ecosystems are subject to particularly high levels of exposure to climatic changes. The disproportionately high value of coastal ecosystems, as well as their high vulnerability to deleterious climate change impacts, makes managed adaptation in the coastal zone a global priority; a wide range of on-ground and institutional approaches have been proposed and implemented.