Floods have become a major climate risk in many countries causing severe material damage to homes, roads, bridges, and other critical infrastructure. The purpose of this chapter is to discuss the relationship between climate change adaptation, prevention and preparedness in the context of flood risk management. Climate change adaptation concerns societal development and includes both preventive measures to reduce the likelihood of unwanted events and preparedness measures to lessen the consequences of those events that are not preventable. However, uncertainty in climate forecasts—especially locally, where municipalities have a central role in climate change adaptation—makes it difficult to carry out risk assessments and analyses that can form the basis for prevention and preparedness and, consequently, for adaptation measures. In addition, there exist challenges linked to municipalities’ capacity to take a risk-based approach to prevention and preparedness. Future extreme weather events and the need for climate change adaptation will place greater demands on risk and vulnerability analyses, legislation, and societal planning, as well as on municipalities’ capacity to handle events related to a changing climate.