Climate change is posing stress on water resources, food security, population, environment and economy of the southern Punjab. Understanding of frequency, severity, damages and adaptation costs of climate extremes of southern Punjab is crucial to deal with their aftermath. Evaluation of PRECIS RCM modelled data under IPCC scenarios in southern Punjab reveals that monthly mean temperature is 30°C under A2 scenario, 2.4°C higher than A1B which is 27.6°C in defined time lapses. Monthly mean precipitation under A2 scenario ranges from 12-15 mm and for A1B scenario it ranges from 15-19 mm. Drought years under moderately (-1 to 1.49) and severely dry (-1.5 to -1.9) conditions obtained from standardized precipitation index SPI-12 calculations of analysis period (1960-2014) are in well agreement with observed drought years in southern Punjab, which validates the accuracy and applicability of SPI tool in monitoring drought conditions. Projected SPI-12 for analysis period of 2010-2098 shows return of moderately and severe dry conditions after every 4 to 6 years. Time periods of 2017-2022, 2049-2054 and 2088-2092 are observing sever dry conditions under both scenarios. Generalized extreme values (GEVs) distribution based on observed climate data shows that occurrence of climate extreme event is a dynamic process and in agreement with observed climate anomalies. GEVs distribution based on projected climate data shows that climate extreme events will occur at different frequency and intensity under IPCC A2 and A1B scenarios. Frequency modelling of floods and droughts via Poisson distribution shows increasing trend in upcoming decades posing serious impacts to all sectors. Cumulative loss projected for frequent floods using loss distribution approach based on Monte Carlo simulation without adaptation will be in the range of USD 66.8-79.3 billion in time lapse of 40 years from 2010 base case. Drought damage function @ 18% for A2 scenario and @ 13.5% for A1B scenario is calculated and drought losses on agriculture and livestock sectors are modelled. Cumulative loss projected for frequent droughts without adaptation under A2 scenario will be in the range of USD 7.5-8.5 billion while under A1B scenario it will be in the range of USD 3.5-4.2 billion for time lapse of 60 years from 1998-2002 base case. Severity analysis of extreme events shows that situation get worse if adaptations are not only included in the policy but also in the integrated development framework with required allocation of funds. Integrated climate change risk assessment is carried out using assessed likelihood approach for defined Mean, Hot & Dry, Central and Warm & Wet climate models over selected time slices and adaptation plans. Climate models are based on the 5th, 50th and 95th percentiles of Providing Regional Climate Impact Studies (PRECIS) RCM projections of temperature and precipitation under IPCC A2 and A1B scenarios. Four time slices 2015, 2035, 2065 and 2085 are selected to assess the temporal climate change risk and to evaluate the performance of selected adaptations to reduce climate threats over considered assets. Results are presented in terms of risk index and risk reduction units (RRUs). In first half of the 21st century, climate change risk will continue to increase from current level and is high (>10) in most of the selected time slices. Maximum ensembles of climate models, time slices and adaptation plans observe moderate (37-40 RRUs) and high (40-55 RRUs) risk class. Cumulative risk is calculated through integration of sectoral sensitivity i.e. population density, land use, food security and multi-dimensional poverty, to climate change risk class using analytical hierarchy process and overlaying in GIS environment. About 90% and 83 % area of southern Punjab is falling in high cumulative risk. About 13 % area, comprising Muzaffur Garh and Rajanpur district is under very high cumulative risk. Water induced adaptations like development of water resources, dam and flood control protection, temporary flood barriers and water resource acquisition are the preferred and suitable adaptations as these observed >100 RRUs for most of the ensembles. Assessing baseline vulnerability and sectoral sensitivity to climate stimuli are the hot spots requiring priority attention and firm decision making by disaster management authorities and communities residing in southern Punjab. Land use change analysis from year 2000 to 2010 over southern Punjab indicate that agriculture area is encroaching rangelands, bare soil is increasing, forest cover is declining, rangelands are depleting and urbanization is at faster pace in the area. This research highlights the result of frequency modelling, sensitivity analysis, severity modelling, cost benefit analysis, benefits of the adaptation options (mean and worst case) for floods and droughts in southern Punjab. This research suggests integrated climate change and cumulative risk assessment methods to quantify and classify sectoral climate change risks. Additionally the research highlights the role of integrated extreme events risk assessment methodology in performing the vulnerability assessments and to support the adaptation decisions. As part of adaptation assessment, GoP/GoPb projects and sectoral adaptations like development of water resources, temporary flood barriers, extreme precipitation events analysis, dam and flood control inspection, flood resistant housing, irrigation and flood management, adaptations of agriculture, livestock, public health, transportation are investigated, appraised and characterized against floods and droughts to build climate change resilience in southern Punjab.