This study examined measures and factors influencing the climate change adaptation decisions of smallholder farmers holding less than 0.5 hectares of farmland. The binary logit model was applied to analyze data collected by face-to-face interviews with 110 households in Phu Vang Coastal District, Thua Thien Hue Province, Central Vietnam. The findings indicate that most farmers accurately perceived climate-related changes during the recent decade, and implemented various adaptation measures in an effort to alleviate the potential risks. Adaptations included changing crop varieties, adjusting farming calendar, diversifying crops, diversifying livestock, improving irrigation, and intensifying soil quality. In addition, the farming household adaptation decisions were positively affected by gender, education level, number of laborers, income level, involvement in local community organizations, and perception of climate change severity and adaptation measure efficacy. Farmer adaptations, in contrast, were negatively influenced by non-farm income and entirely unaffected by access to credit. Policy-related recommendations were proposed to encourage smallholder farmers to adapt to climate change in the region. Recommendations included (1) improvements in the understanding of climate change, especially for female and less educated farmers; (2) more attention paid to the activities of local community organizations to be more attractive for members; (3) participation in the non-agricultural sector in parallel with implementing climate change adaptation measures in agriculture; (4) preferential loans designed as targets for low-income households combined with strict management to avoid misuse by beneficiaries.