Mountain communities in developing and transitioning countries are experiencing a period of rapid social, economic, and environmental change. While change has long been a feature of mountain life, the rate, magnitude, nature, and number of the transformations now taking place is unprecedented, with profound implications for the sustainability and welfare of mountain communities in the coming years. It is therefore vital that their potential impacts be understood. Considering stressors in isolation can give a false picture as each stressor alters the context within which the other stressors are operating. Holistic approaches are needed. In this paper, a variety of stressors are concurrently simulated within an empirically informed agent-based model of a rural Nepalese mountain community so that their combined impact can be studied. The potential effect of changing fertility rates, increasing crop yield variability, and earthquakes on household finances is considered for the period 2015–2030. Results show that higher fertility rates, increased crop yield variability, and earthquakes all have negative long-term effects on household finances, and that each of these stressors compounds the effect of the other stressors in an additive fashion. Results further highlight heterogeneity in the capacity of households to cope with stressors and demonstrate the important role that happenstance can play in exacerbating the effect of stressors. Our findings suggest that development practitioners should explicitly take multiple stressors into account when considering interventions. They should also contemplate improved microtargeting of households to increase aid effectiveness over the longer term, while recognising that household vulnerability is often dynamic.