In the Changthang region of Ladakh, India, pastoralism serves as the cornerstone of both the local economy and the local way of life. However, recent socioeconomic shifts and environmental constraints put this economic structure, which has been expertly adapted to the difficult trans-Himalayan geography, in danger of becoming unsustainable. To explore methods for balancing development, ecology, and Indigenous culture, this review analyzes pastoralism in Changthang. The sole dependable method of food production for generations has been mobile pastoralism, supported by high-elevation rangelands. Breeds of native livestock adapted to scant vegetation and seasonal variation have been selectively bred by generations of pastoralists. Sale of wool and cashmere provides financial stability for pastoralist families, mitigating income vulnerability to climate shocks and market fluctuations that would otherwise disrupt predominantly livestock-rearing livelihoods. However, traditional transhumance cycles and collective resource management have been hampered by sedentarization, population growth, conservation constraints, and market integration. Climate change and unrestricted grazing contribute to grassland degradation. Promising programs combine conventional methods with innovations like mobile veterinary services and satellite forecasting to preserve breeds and grazing resources while increasing productivity and climate resilience. These initiatives seek to support regulated grazing practices. Comanagement practices that involve communities in conservation planning are essential. This production system and culture can be maintained through integrated strategies respecting pastoralists' stewardship.