A systematic review was conducted of biological and physical climate change impacts in three hotspot regions in Africa and Asia. Specifically, the review focused on identifying the nature and extent of biophysical impacts in semi-arid zones, mega-deltas and glacial-fed river basins. In total 139, peer-reviewed articles were reviewed, with a steady increase in relevant articles reported since 2006. Publications on the South Asian glacial-fed river basins were the most numerous followed by semi-arid areas and then deltas, with Central Asia and some African countries being the most under represented. The nature and extent of impacts varied for each hotspot area and were largely determined by the geographical context and intrinsic characteristics of each region. River basin publications were dominated by impacts concerning hydrology, highlighting the importance of glacial-fed water resources to downstream populations. Semi-arid regions were dominated by impacts to climate processes and impacts to livestock and vegetation highlighting the importance of rainfall to the ecosystems and the livelihoods of communities in these regions. In contrast, delta studies were dominated by a focus on hazards, predominantly coastal inundation, reflecting the concentration of populations and assets in these areas. Uncertainties associated with the biophysical impacts on these regions under a changing climate are documented and represent key knowledge gaps. Common information gaps for all hotspot regions were the need for improved hydro-meteorological monitoring systems. The development of climate change adaptation strategies and policies should be supported by a sound knowledge and understanding of the full range of biophysical impacts, which are characteristic to each geographical location.