Rivers have historically been vital to human civilisation, fostering growth and societal evolution. While there has been a shift in population elsewhere, rivers remain hubs of activity, with the advent of new technologies and infrastructure development to attenuate the risk of hazards. However, many traditional communities are still living in river floodplains that routinely face natural hazards such as floods, sediment deposition and channel shifts, which challenge local communities. This article examines the disaster risk adaptation strategies employed by the traditional communities in Gariya Tappu and Gobargada along the Koshi floodplain of Nepal. Data were collected using mixed methods, including household surveys, field observations, and ethnographic methods, to assess adaptation strategies and their interactions. Results show that village relocation in response to shifting river courses and a complete reliance on local material for household construction are the major adaptation strategies. Houses are built using locally available resources and are designed to be dismantled, repaired and transported during the relocation process. The timing and locations of relocation are decided by local institutions, spearheaded by community seniors, based on risk assessments. Such information is crucial for developing a responsive, effective and locally grounded disaster risk reduction strategy in the floodplain areas inhabited by traditional communities.