Abstract Páramo peatlands are a regional reservoir of biodiversity and ecosystem services, accumulating large amounts of carbon and buffering water flows. Despite their importance, they have a long history of use and impacts including drainage for agriculture and grazing, and water withdrawal for human uses. Here we present a preliminary assessment of the conservation status of páramo peatlands in Ecuador and, using a case study, discuss peatland restoration as a tool for mitigation and adaptation to the impacts of current climate change. Through a simple index assessing the cumulative presence of signs of human activities on 163 peatland sites, we found that the level of impact was higher for peatlands located in the Western branch of the cordillera, whereas current human population density, precipitation, and elevation were not significant predictors of the levels of impact. Also, starting in 2017, we implemented a pilot restoration initiative on a 21-ha peatland which had been drained and converted into pasture for at least 150 years. The restoration consisted of two ditch blocking techniques implemented to stop fast-moving water and promote the rewetting of the peatland. During the next 3 years, water table increased from 27 ± 3 cm below the soil surface to 7 ± 1 cm by 2021, while wetland plant communities are colonizing and closing the pools in the blocked ditches. Re-wetting of the peatland has led to an increase in the abundance of native species. This case study suggests that restoration initiatives are an efficient and cost-effective approach to a better management of páramo peatlands, with high potential as a tool for mitigation and adaptation to climate change.