Anthropogenic climate change is rapidly altering aquatic ecosystems across the Rocky Mountain West and may detrimentally impact populations of sensitive species that are often the focus of conservation efforts. The objective of this report is to synthesize a growing literature on these topics to address the following questions: (1) What is changing in climate and related physical/hydrological processes that may influence aquatic species and their habitats? (2) What are the implications for fish populations, aquatic communities, and related conservation values? (3) What can we do about it? In many instances, proactive efforts may help populations adapt to climate change; but elsewhere, transitions of aquatic ecosystems to alternative states may need to be facilitated. The magnitude of the challenges posed by climate change makes collaborative efforts essential among resource disciplines, agencies, and the public.