Agro-based climate adaptation has gained traction in scholarly and policy circles, albeit with limited comprehensive empirical evidence on the pathways of crop sector-specific adaptation approaches in sub-Saharan Africa (SSA). To stem this knowledge gap, this study examines the evolution of farm-based climate adaptation practices in the vegetable subsector of Cameroon’s western highlands. Specifically, we (i) explore the different adaptation practices, (ii) estimate the determinants of farm-based adaptation, and (iii) determine the effects of farm-based adaptation on vegetable performance. Data were collected from a representative sample of farming households (N = 150) in two communities using a semi-structured questionnaire, complemented by key informant interviews (N = 10) and focus group discussions (N = 5). The Product Moment Correlation established an evolution from traditional practices to more modern scientific practices with changing climate, as vegetable farmers shifted from using local seeds to improved ones, intensified pest control strategies and adopted water pump-based irrigation practices. The binary logistic regression model revealed that belonging to farming groups, increase in income and access to credit significantly explained farm-based adaptation (p = 0.041). Furthermore, farm-based practices were significantly reflected in crop performance, mirrored through an increase in vegetable quantity (p = 0.003) and perceived quality (p = 0.046). The results suggest the need for further research to blend traditional and conventional adaptation approaches, and to create enabling environments to foster social capital (belonging to groups) and access to credit as key levers for climate-resilient vegetable production in the western highlands of Cameroon.