The increase in the frequency and intensity of droughts and heatwaves caused by climate change poses a major threat to biodiversity. In aquatic systems, sedentary species such as freshwater mussels are generally considered more vulnerable to changes in habitat conditions than mobile species such as fish. As mussels provide important ecosystem services, understanding the impacts of drought on freshwater mussels is of particular importance for the management of overall functioning of aquatic ecosystems. We used a comprehensive literature search to provide a systematic overview of direct and indirect effects of drought on freshwater mussels (Bivalvia: Unionida) and an evaluation of mitigation strategies. We found that drought studies were concentrated mostly in the USA, with a focus on the Unionidae family. Topics ranged from the physiological effects of high temperatures, emersion, and hypoxia/anoxia to behavioural and reproductive consequences of drought and the implications for biotic interactions and ecosystem services. Studies spanned all levels of biological organization, from individual responses to population‐ and community‐level impacts and ecosystem‐wide effects. We identified several knowledge gaps, including a paucity of trait‐based evaluation of drought consequences, limited understanding of thermal and desiccation tolerance at the species level, and the synergistic effects of multiple drought stressors on mussels. Although we found many studies provided suggestions concerning management of populations, habitat conditions, and anthropogenic water use, a systematic approach and testing of recommended mitigation strategies is largely lacking, creating challenges for managers aiming to conserve freshwater mussel communities and populations in light of climate change.