We analyzed the agricultural land-use changes in the coastal areas of Tien Hai district, Thai Binh province, in 2005, 2010, 2015, and 2020, using Landsat 5 and Landsat 8 data. We used the object-oriented classification method with the maximum likelihood algorithm to classify six types of land uses. The series of land-use maps we produced had an overall accuracy of more than 80%. We then conducted a spatial analysis of the 5-year land-use change using ArcGIS software. In addition, we surveyed 150 farm households using a structured questionnaire regarding the impacts of climate change on agricultural productivity and land uses, as well as farmers’ adaptation and responses. The results showed that from 2005 to 2020, cropland decreased, while aquaculture land and forest land increased. We observed that the most remarkable decreases were in the area of rice (485.58 ha), the area of perennial crops (109.7 ha), and the area of non-agricultural land (747.35 ha). The area of land used for aquaculture and forest increased by 566.88 ha and 772.60 ha, respectively. We found that the manifestations of climate change, such as extreme weather events, saltwater intrusion, drought, and floods, have had a profound impact on agricultural production and land uses in the district, especially for annual crops and aquaculture. The results provide useful information for state authorities to design land-management strategies and solutions that are economic and effective in adapting to climate change.