Implementing Community Based Flood Early Warning System (EWS) in developing countries like Nepal is challenging. Complex topography and geology combined with a sparse network of river and rainfall gauges and little predictive meteorological capacity both nationally and regionally dramatically constrain EWS options. This paper provides a synopsis of the hydrological and meteorological conditions that led to flooding in the Karnali River, West Nepal during mid-August 2014, and analyses the effectiveness of flood EWS in the region.