There is little guidance for the health sector on identifying and prioritizing practical adaptation options to reduce current and projected burdens of climate-sensitive health determinants and outcomes at local and regional levels. An approach is outlined that identifies all theoretically possible adaptation options to reduce adverse climate change-related health outcomes through a search of current practice and experience and through expert solicitation. This theoretical range of choices can then be screened to generate a list of measures that are practical for implementation in a particular population and region. This approach is applied to a theoretical country facing a projected increase in malaria due to climate change. Prioritizing the options should take into consideration technical viability, human and financial resource capacity, compatibility with current policies, and other constraints. Policy makers can combine the information generated with other considerations to select measures for implementation. © 2008 Elsevier Ltd. All rights reserved.