With regional variations, climate change has a significant impact on water quality deterioration and scarcity, which are serious challenges in developing countries and emerging economies. Often, effective projects to improve water management in the light of climate change are difficult to develop because of the complex interrelations between direct and indirect climate impacts and local perceptions of vulnerabilities and needs. Adaptation projects can be developed through a combination of participatory, bottom-up needs assessments and top-down analyses. Climate change impact chains can help to display the causal chain of climate signals and resulting impacts and thereby establish a system map as a basis for stakeholder discussions. This article aims to develop specific climate change impact chains for the water management sector in rural coastal India that combine bottom-up and top-down perspectives. Case studies from Tamil Nadu and Andhra Pradesh, India, provide a basis for the impact chains developed. Bottom-up data were gathered through a vulnerability and needs assessment in 18 villages complemented with top-down research data. The article is divided into four steps: (1) system of interest; (2) data on climate change signals; (3) climate change impacts based on top-down as well as bottom-up information; (4) specific impact chains complemented by initial climate change adaptation options.