Pakistan is adopting an equity-centered adaptation strategy to build resilient health systems in the face of climate-related health risks. Grounded in locally-led initiatives, the approach prioritizes gender inclusion and vulnerable populations. The case study highlights Pakistan’s efforts in strengthening early warning systems, enhancing disease surveillance, and embedding climate adaptation within service delivery and governance frameworks. Through partnerships with local stakeholders and health authorities, the initiative fosters capacity building, equitable resource allocation, and community engagement. This model underlines how participatory, data-informed adaptation can fortify health systems against climate shocks while promoting health equity and long-term sustainability.