Nepal is progressing towards a climate resilient and low carbon health system, encountering various opportunities and challenges. This chapter aims to assess the progress of the Nepalese health system by utilising the 10 building blocks outlined in the World Health Organization’s framework for climate resilient and low carbon health systems. We present findings from a review of policy documents and research articles on climate change and health in Nepal. Our analysis revealed that the Nepalese government has demonstrated its commitments by formulating multiple policies to address climate mitigation, adaptation, and reduction of greenhouse gas (GHG) emissions. The government has been conducting periodic capacity-building activities, funding local evidence generation and adaptation implementation, integrating climate change into health programmes, and developing a framework for reducing GHG emissions. Despite these advancements, Nepal faces numerous challenges. The country’s administrative division into three tiers reportedly results in insufficient communication and collaboration, which is a major obstacle. Additional challenges include the shortage of skilled human resources, limited and inconsistent data, limited access to advanced technology, and insufficient focus on evidence-based research. Nepal is likely to benefit from increased collaboration across various sectors and concerted efforts from the government and private agencies in its aspiration to develop a climate-resilient and low-carbon health system.