In this chapter we review techniques that managers may use to respond to climate change. First, modelling the impacts of climate change on freshwater ecosystems is discussed. While hydro-climatic projections can be used their imprecision requires the selection of robust adaptation options that provide benefits under a range of possible climate outcomes. Second, contested concepts for managing freshwater ecosystems and resources are summarised, and we conclude that they may be used to develop and implement cross-sectoral policies that sustain freshwater ecosystems. Third, options for climate change adaptation for freshwater ecosystems recommends application of six principles, emphasising: accommodation of change; application of ecological and socio-economic targets across multiple scales; maintaining connectivity, conservation of refugia, and representative habitats; initial implementation of no-and low-regret adaptation interventions; agreeing on thresholds for ecological change that trigger new management interventions; and scientific monitoring and evaluation. We conclude by considering how to manage the negative impacts and seize positive synergies in climate change responses: conservation advocates must engage with agriculture, energy, and water resources sectors if freshwater ecosystems are to be incorporated in their decisions.