The Mediterranean region contains some of the areas with the highest urban density in the world, and these areas keep expanding, making this region a “hotspot” of climate change. Life in the Mediterranean unfolds predominantly outdoors throughout the year, exposing its inhabitants to an evolving climate that is progressively harsher and punctuated by increasingly frequent extreme weather events. More and more people are going to be exposed to severe heat waves, droughts, water shortage, dust storms, forest fires and poor air quality on the one hand, and torrential rains and floods on the other hand. The urban heat island further increases thermal stress of city dwellers and plays a key role in citizens' health and well‐being. In this exhaustive review, based on state‐of‐the‐art studies we delve into the realm of climate change and extreme weather phenomena as they intersect with urban populations in Mediterranean cities, both in the present and in the foreseeable future. Our focus lies on identifying knowledge gaps, inconsistencies in observed climatic hazards and shortcomings in assessing the associated risks and their societal and environmental ramifications. Moreover, we undertake a comprehensive survey of future predictions exploring the variables thermal stress, air pollution, air quality and characteristics of the hydro‐climatic systems, that is, droughts, fires and floods. Yet, critical knowledge gaps persist in understanding the science, the coping mechanisms, the strategies for preparedness and adaptation and the intricate interplay between these facets and societal dynamics. The developing countries in the Mediterranean region stand exceptionally vulnerable. It is imperative for more affluent nations to share their expertise and extend assistance to less developed counterparts, aiding them in navigating climate‐related challenges, devising adaptive strategies and facilitating their implementation.