Sustainability consultancy Asia Research and Engagement (ARE) analyzed the risks to 53 of the region's largest ports and estimated costs for them to adapt to rising sea levels and storm surges.
Benjamin McCarron, managing director at ARE, predicted "increasing damage to ports" from storms and related stoppages in operations if measures are not taken to prepare for global warming impacts, including more extreme weather.
"That kind of disruption would grow and continue," he told the Thomson Reuters Foundation.
ARE's report - commissioned by international bank HSBC - covered ports in Japan, China, Hong Kong, Taiwan, Singapore, Australia, India, South Korea and Malaysia.
It put the costs for those ports to adapt to climate change at between USD 31 billion and USD 49 billion.
Japan's Kitakyushu port faces the highest cost at USD 4.9 billion, the report said, while five of the region's 10 largest ports by capacity could see bills of more than USD 1 billion each.
Indonesia's Cilacap could take steps to deal with climate change most cheaply at USD 65 million, the report said.
It is more expensive to fix up ports with large areas covered by warehouses than those made up mainly of yards, which can be elevated relatively easily using concrete, said McCarron.
Port owners should factor the report's findings into their long-term plans and upgrades, while banks, insurance companies, and other investors should question port operators about the resilience of their assets, he added.
Incorporating climate protection at the design stage is cheaper than doing so once a port is built, McCarron said.
The report also urged financial backers of new infrastructures, like China's "Belt and Road" initiative, to ensure they include climate projections in construction plans to avoid higher costs in the future.
"This report is designed to start conversations amongst those who use and finance sea-ports in Asia by asking the multi-billion dollar question: Are you ready for climate change?" Wai-Shin Chan, head of climate change at HSBC, said in a statement.
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