<p>Floods are among the most frequent and damaging natural hazards in Ethiopia’s lowland Gambella region. This study examines household flood adaptation strategies and their socio-economic determinants in the Itang watershed using the Coping Strategy Index (CSI) and a multivariate probit regression model applied to data from 373 households. The findings reveal diverse and context-specific adaptation behaviors shaped by household resilience, livelihood assets, and institutional access. Structural strategies such as house preparation were negatively correlated with mobility and information-based responses, indicating a preference for short-term coping over transformative adaptation among resource-constrained households. Conversely, anticipatory strategies such as crop calendar adjustment, asset elevation, and proper siting were positively associated and reflect greater adaptive capacity, consistent with Resilience Theory and the Sustainable Livelihoods Framework (SLF). Key determinants included gender, education, income, livelihood type, and tenure security. Female-headed households exhibited lower uptake of structural adaptations due to gender-based constraints, while higher education and income facilitated more proactive responses. Livelihood type influenced land-use flexibility, with non-agricultural households facing greater spatial and financial limitations. Tenure security was associated with in-situ adaptation, whereas insecure households favored migration. Additionally, nature-based solutions (NbS) such as watershed rehabilitation and agroforestry were identified as vital for reducing flood risks and enhancing ecosystem-based resilience. The study recommends gender-responsive policies, improved access to education and finance, and participatory land-use planning to support integrated and transformative adaptation in flood-prone areas of the Gambella region.</p>