The sustainability of irrigated agriculture is threatening due to adverse climate change, given future projections that every one in four people on Earth might be suffering from extreme water scarcity by the year 2025. Pressurized irrigation systems and appropriate irrigation schedules can increase water productivity (i.e., product yield per unit volume of water consumed by the crop) and reduce the evaporative or system loss of water as opposed to traditional surface irrigation methods. However, in water-scarce countries, irrigation management frequently becomes a complex task. Deficit irrigation and the use of non-conventional water resources (e.g., wastewater, brackish groundwater) has been adopted in many cases as part of a climate change mitigation measures to tackle the water poverty issue. Protected cultivation systems such as greenhouses or screenhouses equipped with artificial intelligence systems present another sustainable option for improving water productivity and may help to alleviate water scarcity in these countries. This article presents a comprehensive review of the literature, which deals with sustainable irrigation for open-field and protected cultivation systems under the impact of climatic change in vulnerable areas, including the Mediterranean region.