The world’s five Mediterranean-climate regions (MCRs) share unique climatic regimes of mild, wet winters and warm and dry summers. Agriculture in these regions is threatened by increases in the occurrence of drought and high temperature events associated with climate change (CC). In this review we analyze what would be the effects of CC on crops (including orchards and vineyards), how crops and cropping and farming systems could adapt to CC, and what are the social and economic impacts, as well as the strategies used by producers to adapt to CC. In rainfed areas, water deficit occurs mostly during the flowering and grain filling stages (terminal drought stress), which has large detrimental effects on the productivity of crops. Orchards and vineyards, which are mostly cultivated in irrigated areas, will also be vulnerable to water deficit due to a reduction in water available for irrigation and an increase in evapotranspiration. Adaptation of agriculture to CC in MCRs requires integrated strategies that encompass different levels of organization: the crop (including orchards and vineyards), the cropping system (sequence of crops and management techniques used on a particular agricultural field) and the farming system, which includes the farmer.