<p>The Sub-Himalayan and Northeastern regions of India, rich in biodiversity, have long sustained horticulture-based livelihoods, food security and ecological stability. Yet, climate variability manifesting as rising temperatures, erratic rainfall, declining chill hours and shortened dormancy periods is undermining the productivity of traditional temperate crops such as apple (<i>Malus domestica</i>), peach (<i>Prunus persica</i>), apricot (<i>Prunus armeniaca</i>) and several indigenous fruits. While these species, many of which were earlier introductions now naturalized, face declining viability, experimental trials with exotic cultivars including kiwifruit (<i>Actinidia deliciosa</i>), dragon fruit (<i>Hylocereus undatus</i>) and avocado (<i>Persea americana</i>) demonstrate promising adaptability and yield potential under evolving conditions. This review synthesizes agroecological and socio-economic dimensions shaping the integration of both native and exotic fruit crops, highlighting climatic adaptability, soil compatibility, pest–disease resilience, as well as market demand, farmer adoption and livelihood impacts. Using a crop–zone suitability framework, we identify key climatic and edaphic determinants across altitudinal gradients while underscoring strategic adaptation measures such as crop substitution, varietal shifts, elevation reallocation and agroecological intensification. The analysis suggests that diversifying horticulture through a balanced mix of indigenous, naturalized and exotic fruits can enhance climate resilience, reduce import dependence and improve rural incomes. By linking ecological adaptability with market opportunities, this study outlines pathways for a climate-resilient and economically inclusive horticultural future in the Sub-Himalayan context.</p>