This study links climate change impacts to the development of adaptation strategies for agriculture on the Mediterranean region. Climate change is expected to intensify the existing risks, particularly in regions with current water scarcity, and create new opportunities for improving land and water management. These risks and opportunities are characterised and interpreted across Mediterranean areas by analysing water scarcity pressures and potential impacts on crop productivity over the next decades. The need to respond to these risks and opportunities is addressed by evaluating an adaptive capacity index that represents the ability of Mediterranean agriculture to respond to climate change. We propose an adaptive capacity index with three major components that characterise the economic capacity, human and civic resources, and agricultural innovation. These results aim to assist stakeholders as they take up the adaptation challenge and develop measures to reduce the vulnerability of the sector to climate change.