This review article discusses the concept of sustainable adaptation to climate change. It identifies four principles to guide responses to climate change: 1) recognize the context for vulnerability, including multiple stressors, 2) acknowledge that differing values and interests affect adaptation outcomes, 3) integrate local knowledge into adaptation responses, and 4) consider potential feedbacks between local and global processes. The principles argue that fundamental societal transformations are needed to achieve sustainable development and avoid maladaptive responses to climate change. Case studies from diverse contexts illustrate how attention to these principles can help achieve socially just and environmentally sound adaptation.