Many deltas worldwide have increasingly faced extreme drought and salinity intrusion, which have adversely affected millions of coastal inhabitants in terms of lives and property. The Vietnamese Mekong Delta (VMD) is considered one of the world's most vulnerable regions to drought and saline water intrusion, especially in the context of climate change. This study aims to assess livelihood vulnerability and adaptation of the coastal people of the VMD under the impacts of drought and saltwater intrusion. A multi-disciplinary approach was applied, including desktop literature reviews, field surveys, interviews, and focus group discussions with 120 farmers and 30 local officials in two representative hamlets of Soc Trang, a coastal province of the VMD. A vulnerability assessment tool in combination with a sustainable livelihood framework was used to evaluate livelihood vulnerability using the five capital resources to indicate the largest effects of drought and salinity intrusion on the migration of local young people to large cities for adaptation. Livelihood Vulnerability Indexes revealed higher vulnerability in terms of the five capitals of coastal communities living in Nam Chanh hamlet compared to Soc Leo. Results of interviews with officials indicated an optimized mechanism between social organizations and local communities before, at the time, and after being impacted by the drought and salinity intrusion. Our findings contribute evidence-based knowledge to decision-makers to enable coastal communities in the VMD and other deltas worldwide to effectively adapt to the impacts of drought and salinity intrusion.