This paper presents the results of an exploratory study working with two Amazonian communities in Peru to identify key climate-related health risks from the perspective of local residents, and characterize how these risks are experienced and managed. The work adopts a vulnerability-based approach and utilizes participatory methodologies to document and examine local perspectives on vulnerability and adaptive capacity. Thirty nine community members were engaged in participatory photography (photovoice), and rapid rural appraisal workshops were conducted with a total 40 participants. Contextual information was obtained from 34 semi-structured interviews with key informants and participant observation during fieldwork. Three climate-related health risks were identified by the communities as pressing issues (food insecurity, water insecurity, and vector-borne disease), all of which are climate-dependent and reported to be being affected by observed changes in climatic conditions. Sensitivity to these risks is high due to social and economic disadvantages which force people to live in suboptimal conditions, partake in dangerous activities, and engage in unhealthy behaviors. Traditional approaches to health and strong social networks are important in moderating health risks, but are placed under increasing stress in the context of local social and economic changes due to larger scale influences, including resource development, deforestation, and changing social relations. © 2012 Springer Science+Business Media B.V.