Pakistan is among the countries highly exposed and vulnerable to climate change. The country has experienced many severe floods, droughts and storms over the last decades. However, little research has focused on the investigation of vulnerability and adaptation to climate-related risks in Pakistan. Against this backdrop, this article investigates the farm level risk perceptions and different aspects of vulnerability to climate change including sensitivity and adaptive capacity at farm level in Pakistan. We interviewed a total of 450 farming households through structured questionnaires in three districts of Punjab province of Pakistan. This study identified a number of climate-related risks perceived by farm households such as extreme temperature events, insect attacks, animal diseases and crop pests. Limited water availability, high levels of poverty and a weak role of local government in providing proper infrastructure were the factors that make farmers more sensitive to climate-related risks. Uncertainty or reduction in crop and livestock yields; changed cropping calendars and water shortage were the major adverse impacts of climate-related risks reported by farmers in the study districts. Better crop production was reported as the only positive effect. Further, this study identified a number of farm level adaptation methods employed by farm households that include changes in crop variety, crop types, planting dates and input mix, depending upon the nature of the climate-related risks. Lack of resources, limited information, lack of finances and institutional support were some constraints that limit the adaptive capacity of farm households. This study also reveals a positive role of cooperation and negative role of conflict in the adaptation process. The study suggests to address the constraints to adaptation and to improve farm level cooperation through extended outreach and distribution of institutional services, particularly climate-specific farm advisory services.