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Worldwide, millions of people experience coastal flooding each year, with devastating effects especially in rural coastal settlements in tropical developing countries. This paper investigates the vulnerability of local settlements in the Cameroon mangrove forest zone to flooding, and improves understanding of perceptions and responses to past and current coastal flooding. Six communities in the coastal mangrove forest zone of the extreme SouthWest of Cameroon were investigated. A questionnaire was administered to a total of 200 individuals supplemented by other participatory rapid appraisal tools. The ground positions of the sampled sites as well as their altitudes were recorded for subsequent geospatial analysis.Statistical analysis was performed to show trends. The coordinates of the study sites were superimposed on base topographic maps of 1965, to investigate coastal changes over a period of 43 years. Results show that: (1) changes in coastal area have occurred in the past 43 years either through inland retreat or seaward shifts and accordingly, settlements are differentially vulnerable; (2) settlement submergence, house damage, and landscape deformation are the key impacts of flooding; (3) coastal flooding promotes the deforestation of mangrove forest for fuel wood; (4) current adaptive measures include retreat of settlement, abandonment, and house design modifications; and (5) most adaptive strategies are reactive individual actions which are likely inefficient and unsustainable from a longer term perspective given their limited scope of implementation. The paper recommends external support to improve adaptive capacity in mangrove settlements, review and improvement of existing policies, and development of integrated coastal management strategy for the region.