Earthquakes are an existential threat to people around the world, and are one of the most destructive natural hazards in term of both loss of life and financial costs. In response to this threat, a great deal of individual and collective scientific effort over the last 30 years has been aimed at understanding and quantifying earthquake hazard at a range of scales, from global- and national-scale hazard assessments to studies of individual faults. But how do those efforts translate into actions ‘on the ground’ in earthquake-prone areas ? How, in other words, can scientific understanding of earthquakes best be used to support earthquake risk reduction ? Here, I focus on the ways in which our scientific knowledge of earthquake hazard has been used for risk reduction efforts in Nepal. Because of its location along the India-Asia collision zone, Nepal is exposed to high hazard from large earthquakes and their associated effects, including landslides. A large number of national and international organisations are working in Nepal on ways to reduce vulnerability to earthquakes. While we have a growing body of knowledge on the timing, magnitudes, and impacts of earthquakes and landslides, that knowledge is not always useful, usable, or used by those organisations to reduce earthquake risk and to prepare for the next damaging event. I explore how scientific knowledge has been, and could be, used in earthquake risk reduction, from the national scale down to the level of individual communities. I also discuss the importance of relationships and trust between scientists and both individuals and organisations in Nepal who are active in risk reduction efforts. Those relationships are particularly critical in the aftermath of disasters, such as the 2015 magnitude 7.8 earthquake in Nepal. I close by discussing ways in which current research is focused on helping organisations to prepare for the next event, both by using scientific knowledge to help guide reconstruction efforts and through new ways of using earthquake scenarios to anticipate the possible impacts of the next major earthquake.