Climate change and climate variability drive rapid glacier melt and snowpack loss, extreme precipitation and temperature events, and alteration of water availability in the Himalayas. There is increasing observational evidence of climate change impacts on water resource availability and agricultural productivity in the central Himalayan region. Here, we assess the farmers’ perception of climate change and its impacts on agriculture in western Nepal. We interviewed 554 households and conducted eight focus group discussions to collect farmers’ perceptions of temperature and rainfall characteristics, water availability, onset and duration of different seasons, and the impacts of such changes on their lives and livelihoods. Our results indicate that the farmers’ perceptions of rising annual and summer temperatures are consistent with observations. Perception, however, contradicts observed trends in winter temperature, as well as annual, monsoon, and winter precipitation. In addition, farmers are increasingly facing incidences of extreme events, including rainfall, floods, landslides, and droughts. These hazards often impact agricultural production, reducing household income and exacerbating the economic impacts on subsistence farmers. Integrated assessment of farmers’ perceptions and hydrometeorological observations is crucial to improving climate change impact assessment and informing the design of mitigation and adaptation strategies.