The review explores the intricate traditional knowledge (TK) nurtured by the diverse indigenous communities of Northeast (NE) India, emphasizing on their adaptive strategies amidst the region's evolving climate patterns. NE India faces a multitude of climate change-induced risks, including earthquakes, landslides, flash floods, and thunderstorms/lightning, highlighting the critical role of indigenous knowledge in mitigating these challenges. Through generations of experience, indigenous cultures have amassed a treasure trove of traditional ecological knowledge, particularly pertinent in NE India's context. Given the region's vulnerability to climate change impacts, these indigenous practices are indispensable. The review provides an in-depth analysis of these aspects, shedding light on recent climate change impacts, prevalent issues, and the indigenous adaptation strategies in NE India. Recognizing the significance of indigenous knowledge in climate change adaptation, the review stresses the importance of integrating it with scientific knowledge to enhance adaptation effectiveness. It extensively covers various aspects of traditional farming systems, watershed governance, the preservation of biodiversity, and traditional medical practices in NE India. However, the region faces challenges from growing development, the industrial revolution, and devastation, emphasizing an urgent need to document, evaluate, and preserve indigenous cultures' traditional ecological knowledge (TEK).