Small-scale inland capture fisheries provide an important source of nutritious food, employment and income to millions of people in developing countries, particularly in rural environments where limited alternatives exist. However, the sector is one of most under-valued fisheries sectors and is increasingly experiencing environmental change. This study adopts a Sustainable Livelihoods Approach and investigates how important a fluctuating inland fishery is to livelihoods, and how local perceptions on challenges corresponds to global evidence. Through an innovative participatory method; photovoice, the lived experiences and perceptions of fishers are depicted. The findings illuminate the valuable role of the sector to food and nutrition security and the complex nexus with vulnerability to climate change. The study responds to the call for more local level assessments of the impacts of climate change on inland fisheries in data-limited environments, and the value of the sector in underpinning the Sustainable Development Goals.