Smallholder farmers in Nepal are vulnerable to climate change-related extreme weather events. Adaptation in the agriculture sector is needed to mitigate social, economic, and ecological impacts from increasing levels of hazard activity. To examine this issue, a household survey of 350 farmers in the Terai region of Nepal was carried out to assess farmers’ risk perceptions towards three common extreme weather events (floods, cold spells, and heat waves) and to explore their intended responses to cope with future impacts. The intended common adaptation strategies include changes in farm management, seeking off-farm employment, emergency management planning, purchasing crop insurance, and the raising of awareness. Threat appraisal is the strongest predictor of the number of intended adaptation strategies adopted in response to slow-onset hazards (heat waves and cold spells), while coping appraisal is the major predictor of the number of intended adaptation strategies adopted to mitigate flood risk, a rapid onset hazard. Crop insurance and off-farm employment are farmers’ most preferred flood adaptation strategies, while crop insurance is the most preferred adaptation strategy for heat waves and cold spells. Other variables such as the number of past implemented strategies, experience with extreme events, community organisation membership, and access to credit and extension services were also significantly associated with farmers’ choices for adaptation strategies in response to the three extreme events. This information can be used to tailor community-centred communication about potential threats from different extreme weather events and government technical and financial support, which will be crucial for farmers to adapt effectively to climate change-related weather extremes.