Climate change impacts on the hydrology and water resources in East Africa require proper planning of regional adaptation measures. Past studies on the subject matter tended to focus on catchment instead of regional scale. To support actionable policy regarding regional planning of water resources management, this paper reviewed studies conducted in East Africa based on CMIP3, CMIP5, and CMIP6. Compared to the historical condition, temperature of East Africa over the mid- to late 21st century will increase by varying extents over the range 0.17–7°C with about 2.6°C on average. Future precipitation over East Africa will increase by 8.5% on average. Changes in discharge based on CMIP3, CMIP5, and CMIP6 will vary from −25.3 to +60.5%, −42.5 to 129%, and −23.4 to 69%, respectively. Ensemble means of the changes in discharge across the study area based on CMIP3, CMIP5, and CMIP6 will be by 25.2, 19.2, and 19.1%, respectively. Future peak river discharge across East Africa will increase by 8% on average. These results are important for planning regional climate change adaptation across East Africa. To support local or catchment adaptation, results of climate change impacts of temperature, precipitation and discharge of about 50 catchments across East Africa can be found summarized in this review paper. It is recommended that both regional and local policies or approaches should be considered for climate change adaptation to ensure a balanced, effective and sustainable framework for climate resilience in support of measures for tackling broad and specific needs cohesively.