In this concluding chapter, we consider what it means to transform paradigms and practices so as to enhance social equity, resilience and environmental integrity in the face of climate change. Synthesizing some key findings about adaptation from the chapters, we present a framework or ‘roadmap’ that can be used to navigate ‘adaptation as transformation’. We begin by discussing why transformative responses to adaptation and development are necessary. Focusing on three interacting spheres of transformation, we describe entry points for adaptations that reduce vulnerability and contribute to outcomes for global sustainability, of which social equity, resilience and environmental integrity can be considered key components. Finally, we offer some recommendations relevant to those working in bilateral and multilateral aid organizations, in governments and in research, all of whom can potentially play key roles in promoting the transformation of paradigms and practices in support of global sustainability.