Southwest Asia is one of the driest parts of the monsoon region with much of the precipitation concentrated toward the southeast, as well as along the front of the Himalayas. This chapter reviews how humans in Northwest India and Pakistan dealt with changes in precipitation and river course and developed agricultural strategies to mitigate fluctuating rainfall and river load. These strategies included increasing mobility or shifting settlement to areas with higher rainfall, diversification through use of different crops at one site or increasing investment in pastoralism. Finally, a wide variety of small-scale irrigation systems were likely employed that were uniquely attuned to their local environment. Some of the strategies, such as the adoption of arid adapted millets employed by these farmers, may represent useful adaptations for our future.