The potential impacts of climate change on the food security of subsistence farmers is a serious concern. This article explores the food security situations of two categories of subsistence farm households, vegetable- and cereal-based farming systems, in the Makwanpur district of Nepal in the context of climate change. Local climate data for the past 30 years were analyzed. Interviews with local farmers and key informants, and focus group discussions were carried out to collect the primary data. Empirical data showed that changes in climate variables for the study period were in line with farmers' perceptions and that farming communities were negatively impacted. Perceived impacts were erratic rainfall, increased frequency of floods and droughts, soil degradation and insect pests, weeds and diseases. Farmers have modified traditional cropping patterns and calendar, changed crop varieties and increased fertilizer and pesticide applications in order to maintain crop yields. They have also sought off-farm employment. However, agricultural productivity in the area is declining and only one third of all households in the area were food secure. Household food insecurity was at mild to moderate levels, but vegetable-based households were more secure than cereal-based ones. At the household level, locally successful adaptive measures, such as rainwater harvesting, mulching, planting date adjustments, off-farm opportunities, including infrastructure and extension support, could increase production and contribute to reversing the impact of increased risk attributed to climate change.