Since the implementation of economic reforms in 1986, the Mekong Delta has experienced an extensive transformation process in its agricultural sector. This transformation has been characterized by agricultural intensification, the enhanced use of agrichemicals (fertilizer, pesticides), and emerging concerns for human health and the environment. The predicted impacts of climate change such as sea level rise, greater seasonal variability in precipitation and river flows, and elevated temperature and CO2 concentration will all likely also influence the agricultural landscape and thus agrichemical use. Against the background of the anticipated climate change impacts in the Mekong Delta, this chapter aims to draw a scenario for future agrichemical use and attendant environmental problems. This scenario is achieved through a review of the main climate change-mediated drivers for agrichemical use, with a focus on land-use changes and changes in pest and disease patterns. In addition, the chapter identifies possible adaptation measures that may be implemented by the agricultural sector in the Mekong Delta and explores the potential environmental effects of these adaptation strategies.