Abstract It has been previously noted that neural machine translation (NMT) is very sensitive to domain shift. In this paper, we argue that this is a dual effect of the highly lexicalized nature of NMT, resulting in failure for sentences with large numbers of unknown words, and lack of supervision for domain-specific words. To remedy this problem, we propose an unsupervised adaptation method which finetunes a pre-trained out-of-domain NMT model using a pseudo-in-domain corpus. Specifi- cally, we perform lexicon induction to extract an in-domain lexicon, and construct a pseudo-parallel in-domain corpus by performing word-for-word back-translation of monolingual in-domain target sentences. In five domains over twenty pairwise adaptation settings and two model architectures, our method achieves consistent improvements without using any in-domain parallel sentences, improving up to 14 BLEU over unadapted models, and up to 2 BLEU over strong back-translation baselines.