As climate hazards and extreme weather impacts intensify and public systems across the United States face growing strain, mutual aid—understood as grassroots, reciprocal networks of care and solidarity—can be understood as a critical yet under recognized form of climate resilience. While most academic and policy attention has situated mutual aid within the context of COVID-19, its significance extends across both sudden-onset disasters, such as heat waves, hurricanes, and winter storms, and ongoing structural crises, including housing and food insecurity. Across these contexts, mutual aid operates as flexible, trust-based infrastructure: networks that mobilize quickly, adapt to changing conditions, and sustain forms of care that formal institutions often struggle to provide. This talk highlights the role of mutual aid within a climate adaptation and resilience framing, in Seattle, Washington and Asheville, North Carolina and draws upon semi-structured interviews to examine possibilities and challenges to collaboration with formal health institutions and local governments. Attention to these dynamics highlights both the possibilities and tensions that emerge in relation to formal institutions, with implications for how climate adaptation, disaster response, and structural inequities are understood and addressed.