Climate change has already led to a wide range of impacts on our society, the economy and the environment. According to future scenarios, mountain regions are highly vulnerable to climate impacts, including changes in the water cycle (e.g. rainfall extremes, melting of glaciers, river runoff), loss of biodiversity and ecosystems services, damages to local economy (drinking water supply, hydropower generation, agricultural suitability) and human safety (risks of natural hazards). This is due to their exposure to recent climate warming (e.g. temperature regime changes, thawing of permafrost) and the high degree of specialization of both natural and human systems (e.g. mountain species, valley population density, tourism-based economy). These characteristics call for the application of risk assessment methodologies able to describe the complex interactions among multiple hazards, biophysical and socioeconomic systems, towards climate change adaptation. Current approaches used to assess climate change risks often address individual risks separately and do not fulfil a comprehensive representation of cumulative effects associated to different hazards (i.e. compound events). Moreover, pioneering multi-layer single risk assessment (i.e. overlapping of single-risk assessments addressing different hazards) is still widely used, causing misleading evaluations of multi-risk processes. This raises key questions about the distinctive features of multi-risk assessments and the available tools and methods to address them. Here we present a review of five cutting-edge modelling approaches (Bayesian networks, agent-based models, system dynamic models, event and fault trees, and hybrid models), exploring their potential applications for multi-risk assessment and climate change adaptation in mountain regions. The comparative analysis sheds light on advantages and limitations of each approach, providing a roadmap for methodological and technical implementation of multi-risk assessment according to distinguished criteria (e.g. spatial and temporal dynamics, uncertainty management, cross-sectoral assessment, adaptation measures integration, data required and level of complexity). The results show limited applications of the selected methodologies in addressing the climate and risks challenge in mountain environments. In particular, system dynamic and hybrid models demonstrate higher potential for further applications to represent climate change effects on multi-risk processes for an effective implementation of climate adaptation strategies.