Climate change is the biggest global challenge and an imminent threat to public health. The threats are particularly severe in low- and middle-income countries like Pakistan, which are often the least able to respond. Pakistan is among the countries that are most vulnerable to the risks associated with climate change. Pakistani women and girls in general, and poor rural women in particular, are the largest and most vulnerable group and unduly victims of climate change-triggered disasters. This study aimed to engage with local communities living at the country’s largest natural water reservoir sites to investigate their understanding of climate change and its impacts. We used a gender analysis approach that informed the data collection using qualitative (focus groups, interviews and observations) and quantitative (household survey) methods. In total, 226 community members and 10 government officials participated from 6 locations in four provinces. The study found inadequate knowledge and awareness concerning climate change and its impact among the research participants. On the hand, most of the participants were aware and highly concerned with post-disaster (e.g., flooding, heavy rain and extreme weathers) health impacts, such as the spread of water- and vector-borne diseases, diarrhoea, skin infections, malaria, dengue, and malnutrition. Women participants expressed their views about the disproportionate impact of such disasters during their pregnancy and delivery. Government officials who participated in the study knew that climate change triggers natural disasters, a challenge for the country. Still, most of them believed that these were natural disasters, thus, not in their control to prevent them. This study concludes that women and men in these sites lack resources, knowledge and information about climate change and its risks to population health. Thus, the study recommends that decision-makers engage with these communities to raise their knowledge about climate risks and build their capabilities to mitigate them.