Loss and damage (L&D) is rapidly becoming a significant focus of international climate agreements, following the failure to-date of developed countries to adequately stem greenhouse gas emissions, and a number of high profile, and costly, extreme weather events. This ACT2015 paper explores some of the key issues relating to adaptation and L&D, and outlines options for addressing them in the 2015 agreement. The objective of the paper is to identify the central questions and dilemmas concerning adaptation and L&D, and to elaborate on some proposed approaches that are already in circulation. The paper opens by charting the last 15 years of climate negotiations from the perspective of both climate change adaptation and L&D, from the seventh Conference of Parties (COP7) held in 2001, where adaptation first received serious attention, through the introduction of concrete L&D-based outcomes at COP13 (2007), and on to the establishment of the Warsaw International Mechanism for Loss and Damage (WIM) at COP19 (2013). Under WIM, an executive committee was given a mandate to implement a two-year plan with the aim of enhancing knowledge and understanding of comprehensive risk management approaches, identifying knowledge gaps, and enhancing data and response measures concerning non-economic losses associated with climate change, including slow-onset events. The paper then goes on to outline a number of key issues and options for climate adaptation. Integrating mitigation, adaptation, and L&D is recommended since the cause and effect relationship between these three components make them strategically complementary, requiring a balance mix of approaches to provide optimal and synergistic reductions in damage. The extent to which this is institutionalised is the variable within the options recommended. Beyond this, options are presented on the issue of a global goal on adaptation, from setting a long-term financial goal based on existing estimates, to non-financial goals based on results. Additionally, options are put forward with regard to the scope of adaptation activities, and institutional options for governing adaptation. Finally options for addressing L&D are discussed, including the function and scope of the WIM, and institutional arrangements for adaptation and L&D integration. These include enhancing the scope of the Adaptation Committee as the overarching governance arrangement for both adaptation and L&D, and adaptation and L&D having equal, yet separate, institutions. Options for cross-cutting issues like equity, finance, and technology transfer, capacity building, and measurement, reporting, and verification are discussed, before finally the paper considers linkages with external institutions and mainstreaming in the context of the Sustainable Development Goals, and the upcoming post-2015 framework for disaster risk reduction.