As comparative multi-country studies are rare, not much is known about the effects of regional differences in social-ecological conditions on the adoption of climate risk management practices in aquaculture. This study is based on a large-scale survey of practices of aquaculture operators in Cambodia, Laos, Myanmar, Thailand, and Vietnam. Climate-related risks to profits of aquaculture farms in the Mekong Region are typically managed alongside water-related, disease and other business risks. Farmers who were more concerned with risks to profitability had a history of undertaking more risk management practices. Farmers growing shrimp (rather than fish), or adopting more intensified production systems, had more risk management practices. Wealthier and more educated farmers had experience with more practices for dealing with current risks, as well as recognized the need for strategies to adapt to a changing climate in the future. Information access is a factor in the adoption of new practices and strategies. Adoption of aeration or use of information-communication technologies to manage climate-related risks, for example, was more likely among more educated and wealthy farmers who belonged to growers’ groups. The findings also suggest that attitudes toward innovation, levels of investment and social norms influence adoption of technological, organizational and informational practices.