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Regions with a Mediterranean climate are generally predicted to become warmer and drier with climate change. Estuaries in these regions are influenced by a broad range of climate drivers and are particularly vulnerable to the effects of climate change. We examine observed and predicted effects of climate change on the estuaries of south-western Australia (SWA), where sustained warming and drying trends have caused dramatic declines in freshwater flows of up to 70% since the 1970s, as a case study of the impacts that might be expected in other Mediterranean regions. Current and projected impacts of climate change in SWA include progressive warming and ‘marinisation’ of estuaries; extended closure of periodically open systems; an increased frequency and severity of hypersaline conditions; enhanced water column stratification and hypoxia; and reduced flushing and greater retention of nutrients …