Toxic and harmful algal blooms (HABs) are a global problem affecting human health, marine ecosystems, and coastal economies, the latter through their impact on aquaculture, fisheries, and tourism. As our knowledge and the techniques to study HABs advance, so do international monitoring efforts, which have led to a large increase in the total number of reported cases. However, in addition to increased detections, environmental factors associated with global change, mainly high nutrient levels and warming temperatures, are responsible for the increased occurrence, persistence, and geographical expansion of HABs. The Chilean Patagonian fjords provide an “open-air laboratory” for the study of climate change, including its impact on the blooms of several toxic microalgal species, which, in recent years, have undergone increases in their geographical range as well as their virulence and recurrence (the species Alexandrium catenella, Pseudochattonella verruculosa, and Heterosigma akashiwo, and others of the genera Dinophysis and Pseudo-nitzschia). Here, we review the evolution of HABs in the Chilean Patagonian fjords, with a focus on the established connections between key features of HABs (expansion, recurrence, and persistence) and their interaction with current and predicted global climate-change-related factors. We conclude that large-scale climatic anomalies such as the lack of rain and heat waves, events intensified by climate change, promote the massive proliferation of these species by creating ideal conditions for their growth and persistence, as they affect water-column stratification, nutrient inputs, and reproductive rates.