Climate change is impacting the subsistence livelihoods of many indigenous communities in the Arctic. We describe how structured decision analysis (SDA), informed by traditional ecological knowledge, can be used to understand the mechanisms of how climate change influences subsistence species and their harvest, and to build upon existing adaptive strategies and decision-making processes. In the Iñupiat community of Wainwright, Alaska, we test SDA as a potential framework by which vulnerabilities of subsistence systems can be identified and climate change adaptations can be prioritized. Over the course of five workshops, participants identified issues of concern, assessed the benefits and trade-offs of different strategies to enhance the safety of subsistence activities, identified factors influencing key subsistence species and their accessibility, and assessed the dependence of animals and their harvest on sea ice. Furthermore, we asked workshop participants to assess whether subsistence resources have increased, decreased, or remained stable over the past decade. Declining caribou populations and unsafe ice conditions for hunters were of particular concern in Wainwright. Participants identified high priority safety strategies such as a new docking facility, safety workshops, a hunter meeting place, and search and rescue boats. Because of its coastal location on a lagoon at the mouth of a river, Wainwright has a highly diverse subsistence system that may in part buffer the negative effects of climate change. Furthermore, most species or groups harvested in Wainwright were assessed as stable or increasing. Nevertheless, of the five most important subsistence species in Wainwright, one experienced recent population declines (caribou) and the harvest of three others depends on the presence of thick, reliable shorefast ice. We propose that SDA can be a useful tool to assess the vulnerability of subsistence systems to climate change, and can be used to prioritize strategies to adapt to climate change.