Periodic drought is a major challenge in drought-prone areas of South Asia. A sample survey of farmers (n = 400) from South Asia was conducted to study the farmers’ perception about drought impacts on their socio-economic status, agro-biodiversity, and adaptation besides public institutions’ drought mitigation measures. The results revealed reduced surface and groundwater availability, soil degradation, partial or complete crop failure, increased agricultural fallows and wastelands, biodiversity loss, decrease in agricultural yields, pasture lands, and livestock in drought-impacted South Asia. About 16–26% of the farmers perceived a reduction in the agricultural area and production of commercial crops and millets in drought-prone areas, while changes in the cropping of pulses, oilseeds, horticultural, and fodder crops were minimal. About 57–92% of respondents showed a reduction in the consumption of fruits, vegetables, dairy products, and fish. Unemployment, migration, reduced farm income, and malnutrition were major socio-economic impacts among respondents (38–46%). Despite sufficient public support as a mitigation strategy, the farmers had poor participation (8–65%) for agri-information and adaptation (7–36%) against drought impacts. Hence, researchers, extension agents, and policymakers must develop efficient ‘participatory-mode’ drought adaptation and mitigation policies in watershed-based semi-arid pastoral and agricultural regions of South Asia and similar agro-ecologies across the globe.