Climate change introduced new challenges to vinegrowers in the Mediterranean areas such as the hot and dry winegrowing region of Alentejo, south Portugal. Warmer and drier conditions are harmful for grape yield and berry quality attributes and for vine's longevity, mainly when optimal thresholds are exceeded. Therefore winegrowers are forced to move from rainfed to irrigated production systems making Alentejo' wine production strongly based on available water resources for irrigation. This work aims to review and discuss ecophysiological and agronomical data obtained in irrigation trials set up at different terroirs of Alentejo. In the last four decades, classical bioclimatic temperature-based indices showed a significantly positive trend, while the dryness index present a negative trend over time. Furthermore, ecophysiological data collected in deficit irrigation experiments are reviewed and discussed, focusing on the effects of drought and heat stress on vigour, yield and berry composition. Emphasis is given on the indirect effects of leaf senescence on cluster exposure and consequences on berry temperature and composition. In order to promote the sustainability and quality of wine production in these hot and dry terroirs short- to long-term adaptation measures are suggested. The limitations and risks of using deficit irrigation during heat waves are also underlined.