BackgroundClimate change in Nepal has posed a considerable challenge to agricultural productivity and has threatened food and nutritional security at multiple levels. This study aims to assess the impacts of climate change on national food production and food and nutritional security as well as document issue-based prioritized adaptation options for a resilient food production system. MethodsThis study considers temperature, precipitation, and their anomalies as the key factors affecting food production in Nepal. Nationwide precipitation trends along with their association with the annual production of major cereal crops in Nepal were assessed using data from the last three decades (1990-2018). The annual productions of the major cereal crops were summed and normalized to calculate the production index scores in the districts. Scores were plotted and visualized into maps using the Geographical Information System. In three ecological regions, the distribution of flood and extreme rainfall events and cases of malnutrition from 2005 to 2018 were plotted. The effects of climate change and highest priority adaptation options at the district level were documented through a review of national policies and literature studies and qualitative research based on Focus Group Discussions (FGDs). ResultsBetween 1990 and 2018, the overall average production of major cereal crops in Nepal was increased by around 2,245 MT annually. In the district level index analysis, the highest production score was found for Jhapa and Morang while the lowest production score was found for Humla. Cases of malnutrition in some districts coincided with flood and heavy rainfall events, indicating that climate change and extreme climatic events have a role to play in food production and security. Growing drought-tolerant crops, changes in crop cycle, riverbed farming practices, developing short-term strategies, such as contingency crop planning, changing planting dates, planting short duration varieties, schemes evacuation, and long-term strategies, such as encouraging out-migration of population to safer locations, resettlement programs with transformative livelihood options, and sustainable agricultural practices were found to be key prioritized adaptation measures for a resilient food production system. ConclusionIn Nepal, climate change and the increasing frequency and magnitude of extreme climatic events adversely affect the food production system, which has become a serious threat to food and nutritional security. The implementation of evidence-based practices to build a resilient food system specific to climate-vulnerable hotspots at the district and local levels is the nation's current need.