Changing precipitation patterns including more intense and prolonged dry periods have become a growing concern for people living in the Pacific Island region. People in the region are particularly sensitive to these changes given their resource-based livelihoods and high dependence on rainfall for their freshwater needs. Despite this, little attention has been given to understanding the implications of climatic changes for people and their capacity to manage these changes. This paper assesses human vulnerability to climate change (as it relates to fresh water resources) in Vusama, an iTaukei village in southwest Viti Levu, Fiji in the context of recent social and ecological changes. An analysis of data collected using a vulnerability approach that included semi-structured interviews, participant observation and analysis of secondary sources reveal that climate change together with behavioural changes are negatively affecting availability and access to clean freshwater, with implications for household economies, food security and human health. In particular, prolonged drought and changing seasonal patterns, together with people’s increasing reliance on a village borehole in lieu of family wells have resulted in a freshwater crisis. People are coping by using earnings from wage employment and harvesting and selling seafood to buy water and vegetables, rationing freshwater and depending on extended social networks for fresh produce. Current responses are reactive and short-term. Longer-term adaptation strategies are needed that consider expected future climate change and broader human development goals.