Climate warming, sea level rise, and extreme weather events are creating intensifying and more frequent hazards for human populations inhabiting the coast. In Alaska’s remote coastal communities, flooding and erosion are rapidly increasing due to the combined effect of sea level rise, more frequent storm surges, and increasingly powerful wave action from lack of sea ice. This paper presents survey results documenting socio-economic and psychological livelihood impacts and relocation preferences as reported by residents of a remote coastal Indigenous community. We quantified direct costs of lost or damaged private property, affected community infrastructure, and interruption of public services and found that the resulting financial hardship adds to existing economic challenges and climate stressors. Findings underline a community-level preoccupation with coastal climate threats that manifests primarily in intrusive and distressing thoughts of consequences from storms and other destructive climatic events. We highlight the need to monitor more broadly livelihood impacts to inform the design of innovative risk management tools to moderate financial hardship and strengthen community-driven action. We conclude that new policy responding to the needs of remote Indigenous communities affected by repetitive environmental disasters needs to account for a complex array of community and culture-specific socio-economic, health, and biophysical factors that require frequent co-produced assessments to capture rapidly changing conditions at the local scale.