Countries in Asia and the Pacific face a heightened risk of flooding as disasters increase worldwide due to climate change. Yet these countries often lack the infrastructure necessary to prepare for and respond to floods effectively. When flood protection measures exist, they generally rely only on grey, hard-engineered infrastructure, which has been increasingly challenged in recent years. Nature-based solutions (NbS) offer a new approach for flood management, with several co-benefits beyond the reduction of risks. This approach has gained recognition from policy makers in the region, but they are confronted with a number of challenges, including the lack of a clear, common definition and guidelines, as well as financing issues. The growing imperatives of climate adaptation call for complementary, innovative and forward-looking solutions, such as a combined approach incorporating both NbS and grey infrastructure.