How people subjectively perceive climate change strongly influences how they respond to its challenges. To date, relatively little is known about such perceptions in the Global South. This research examines public perceptions of climate change in the Peruvian Andes, a semi-arid high-mountain region that is highly exposed and vulnerable to adverse effects of climate change. Based on questionnaire data collected through face-to-face interviews (N = 1316), we found that respondents identify various climate-related issues as the most important challenges for their country. Many of these issues are related to water. Respondents also noticed more subtle changes and expected them to continue (e.g., extreme temperatures, food shortages). Climate impacts were clearly seen as negative, which was also reflected in the presence of emotions. When compared to previous research, more respondents had personally experienced extreme weather events (80%) and they were more certain that the climate is already changing, is caused by human activity, and is affecting distant and close places similarly. A comparison of the perceptions along different socioeconomic characteristics suggests that more vulnerable groups (e.g., rural, low income and education levels) tended to perceive climate change as more consequential, closer, and as a more natural (vs. anthropogenic) phenomenon than those from less vulnerable groups. The salience of water-related problems and personal experiences of climate-related events, as well as differences between various subgroups, could be used to improve measures to adapt to the consequences of climate change by correcting misconceptions of the population and of decisionmakers.