Rice (Oryza sativa L.) serves as a staple food for over half the global population, but its cultivation faces significant challenges from abiotic stresses such as drought, salinity, temperature extremes, and heavy metal toxicity. These stresses adversely impact rice growth, yield, and quality, posing a threat to global food security. This review comprehensively explores the physiological, biochemical, and molecular responses of rice to abiotic stresses, highlighting key functional genes and signaling pathways. Advanced breeding strategies, including molecular marker-assisted selection (MAS), genome-wide association studies (GWASs), and CRISPR/Cas9-based genome editing, offer innovative solutions for enhancing stress tolerance. Integrated approaches combining traditional breeding, modern molecular techniques, and exogenous applications such as plant hormones and beneficial microorganisms are discussed. These methods aim to develop rice varieties resilient to multiple stresses, ensuring sustainable production. Future prospects emphasize the integration of multi-omics technologies and the establishment of stress-resistant germplasm banks to accelerate breeding programs. This review provides some support for the development of stress-tolerant rice varieties to help address agricultural challenges in the context of climate change.