Climate change, deforestation and hydropower dams are contributing to environmental change in the Lower Mekong River region, the combined effects of which are felt by many rural Cambodians. How people perceive and manage the effects of environmental change will influence future adaptation strategies. The objective of this research was to investigate whether the use of a low-cost, explicitly spatial method (participatory mapping) can help identify locally relevant opportunities and challenges to climate change adaptation in small, flood-prone communities. Four villages along the banks of the Mekong River in Kratie Province, Cambodia, were the subject of this research. To identify perceived environmental hazards and adaptive responses, eight workshops were conducted using focus-group interviews and participatory mapping. The communities’ responses highlight the evolving nature of environmental hazards, as droughts increase in perceived importance while the patterns of wet season flooding were also perceived to be changing. The attribution of the drivers of these hazards was strongly skewed towards local factors such as deforestation and less towards regional or global drivers affecting the hydrology of the Mekong and climate patterns. Combining participatory mapping with focus-group interviews allowed a greater depth of understanding of the vulnerabilities and opportunities available to communities than reliance on a single qualitative method. The study highlights the potential for a bottom-up transfer of information to strengthen existing climate change policies and tailor adaptation plans to local conditions.