Pakistan is among the countries that are highly vulnerable to climate change. The country has experienced severe floods and droughts during recent decades. The agricultural sector in Pakistan is adversely affected by climate change. This systematic review paper set out to analyze the existing literature on adaptation measures at the farm level toward climate change in Pakistan. Adopting a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, a total of 62 articles were identified from the Web of Science and Scopus databases. The review paper indicates that the main adaptation strategies adopted by farmers are as follows: changing cropping practices, changing farm management techniques, advanced land use management practices, and nonagriculture livelihood options. Further, this review shows the factors influencing the farmer’s adaptation measures to climate change. Influencing factors were examined and classified into three groups: demographic, socioeconomic, and resources and institutional. Barriers hindering farmers’ adaptive capacity were identified as lack of access to information and knowledge, lack of access to extension services, lack of access to credit facility, and lack of farm resources.