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This paper investigates the perceived and observed trends of associated health risks with seasonal climate variability and identifies types of and preference for adaptation strategies that are available at households and community levels in Oke-Ogun region, Nigeria. The study made use of household survey and rapid appraisal through focus group discussion and key informant interviews. For a short term climate–health impacts analysis, cases of notable diseases were correlated with monthly mean temperature and rainfall for the period 2006 and 2008. The findings show similar trends in relation to local perception on climate–health risks and observed cases of some notable diseases during seasonal changes. Diarrhea, measles and malaria were prevalent during dry season, while flu cases increased at the onset of harmattan and monsoon of rainy season. Available adaptation strategies are autonomous, mostly in the form of treatment measures such as consultation with medical officers in hospitals (17.5%), self-medication (34%) and use of traditional therapy such as herbs (48.5%). Traditional therapy is mostly preferred and approved based on long-term experience of the study population.Trends of perceived and observed cases of health risks related to seasonal climate variability are similar.Cases of diarrhea, measles and malaria increase with increase in temperature.Cases of flu increase during the onset of harmattan and monsoon of rainy season.Coping and adaptation strategies ensured when ill-health impacts are perceived by the study population.Indigenous therapy is mostly autonomous, mostly preferred and approved based on long-term experiences of the study population.