A survey of 479 smallholder farmers in two villages in rural northeast Madagascar found that nearly all participants reported perceiving increases in temperature (94%) and decreases in rainfall (91%) in the previous five years, and most reported that they expect to have much less (57%) or somewhat less (35%) food to feed their families in the future due to changes in temperature and rainfall. Despite these concerns, few participants (21%) reported changing their farming practices to adapt to climate change. Farmers who had greater market-based wealth had higher odds of adopting new farming methods, and men had higher odds of adopting new farming methods than women. These results suggest that climate change is a significant challenge for farmers in northeast Madagascar, yet adaptation is limited by existing socioeconomic inequalities involving access to market activities and gender.