Cotton is one of the key cash crops in Pakistan, significantly contributing to the economy and supporting the livelihoods of the farming community. However, this promising sector faces major threats from global warming and climate change. A study was conducted in District Muzaffargarh to assess the adoption of sustainable cotton farming practices. This area was chosen as it is a major cotton-producing region in Pakistan. A total of 270 cotton growers were randomly selected for data collection. The data were analyzed using the Statistical Package for Social Sciences (SPSS). Additionally, five focus group discussions were conducted to gather qualitative insights. The results revealed that a limited number of cotton varieties were cultivated in the region, with SS, CKC, IUB, BS, and NIAB being the most common. An overwhelming majority of the farmers had cotton fields of up to 5 acres. Hand sowing was the most common planting method. Among water stewardship practices, irrigation after weather forecasts, cleaning of watersheds, and reduced use of flood irrigation were prevalent. In terms of soil improvement practices, foliar spraying, soil analysis, reduced pesticide usage, and reliance on farmyard manure were widely adopted. Regarding Integrated Pest Management (IPM) practices, rotavating crop residue, proper disposal of cotton sticks, the use of recommended pesticide doses, and the application of appropriate active ingredients were the most common practices.