In 2011 the North Bank Region of The Gambia experienced its most severe drought in 20 years. This article looks at how this drought affected households in the region, the coping measures they adopted, and residual loss and damage. In this study, 'loss and damage' is defined as adverse effects of climatic stressors that people have not been able to avoid through coping and adaptation (from Warner et al., 2012). Data were collected through a questionnaire survey (N = 373), 60 focus group discussions and six expert interviews. Almost all respondents reported that the 2011 drought had affected their household, particularly through crop failure, livestock losses and high food prices. Most households tried to cope by seeking non-farm income or selling livestock to buy food. Others relied on food aid or social networks. However, for almost two thirds of the households, these measures were not sufficient or had adverse effects.