This paper presents an analysis of the benefits of climate change adaptation from small and medium scale hydropower plants in Lao Cai Province. Lao Cai is a mountainous province with high hydropower potential. Totally 116 small and medium hydropower projects in different stages of development have been identified with installed capacities ranging from MW to 60 MW. Based on the results of statistic downscaling, four climate change scenarios were developed for the Lao Cai province area. Impacts of small and medium scale hydropower plants, both negative and positive impacts, on water resources, rural development, social economic and.