Latin America and the Caribbean (LAC) use nature-based solutions (NBS) as a tool for contributing to sustainable development and reduce climate change impacts. NBS projects in the region contribute both to adaptation and mitigation agendas and make use of a wide variety of solutions to help restore and protect region’s forests, grasslands, mangroves, coral reefs, and urban parks, among others. They represent an important opportunity for national and subnational governments, infrastructure service providers, and private sector to ensure that several chronical unsolved issues like improving water supply, enhancing water quality, and decreasing water consumption are better addressed. The idea of this chapter is to review the practice of these projects, to describe them, and to analyze their role in LAC. We also provide a regional overview of NBS initiatives, their current state, and their link with international frameworks like the Paris Agreement to map out a future course in climate change adaptation and mitigation efforts. We propose that the region is transitioning from piloting NBS to widespread adoption, which could significantly transform infrastructure planning, ecosystem restoration, and climate action. Integrating NBS into national planning frameworks like the Nationally Determined Contributions (NDC) or the Sustainable Development Goals (SGDs) is also ongoing, and it has the potential to enhance these transformations efforts toward a more effective approach to environmental management.