Flood, storm, and drought have frequently impacted households in the U-Tapao River Sub-basin, Songkhla Province, Thailand, as a result of climate change. Studying how to assist them in better adapting to the effects of climate change is a critical mission that researchers should strive to achieve. The goals of this study are to (1) investigate the effects of climate change on households in the U-Tapao River Sub-basin, (2) examine the adaptation strategies they used, (3) the challenges they faced when attempting to adapt, and (4) provide recommendations for future adaptation. The study was carried out in the jurisdictions of three local government authorities. A survey questionnaire was used to collect quantitative data from 300 households, which was then analyzed using frequency, percentage, mean, and standard deviation. To supplement survey data, qualitative data were collected from 50 key informants via in-depth interviews and focus-group discussions. Climate change impacted households in four ways, according to the findings: health, housing, agriculture, and livelihood activities. Although households can take general measures to mitigate the effects of climate change on their health and livelihood, they do not appear to be able to take preventive measures to minimize flooding impacts on their house and property, nor do they appear to be able to adopt on-farm adaptation strategies to prevent income loss. The main impediment to taking more effective measures is a lack of funds, knowledge, and technical assistance. As a result, practical recommendations are provided at the end of this paper to help overcome such challenges and encourage households to adopt more adaptation strategies.