Nearly all regions in the world are projected to become dryer in a warming climate. Here, we investigate the Mediterranean region, often referred to as a climate change “hot spot”. From regional climate simulations, it is shown that although enhanced warming and drying over land is projected, the spatial pattern displays high variability. Indeed, drying is largely caused by enhanced warming over land. However, in Northern Europe, soil moisture alleviates warming induced drying by up to 50% due to humidity uptake from land. In already arid regions, the Mediterranean Sea is generally the only humidity source, and drying is only due to land warming. However, over Sahara and the Iberian Peninsula, enhanced warming over land is insufficient to explain the extreme drying. These regions are also isolated from humidity advection by heat lows, which are cyclonic circulation anomalies associated with surface heating over land. The cyclonic circulation scales with the temperature gradient between land and ocean which increases with climate change, reinforcing the cyclonic circulation over Sahara and the Iberian Peninsula, both diverting the zonal advection of humidity to the south of the Iberian Peninsula. The dynamics are therefore key in the warming and drying of the Mediterranean region, with extreme aridification over the Sahara and Iberian Peninsula. In these regions, the risk for human health due to the thermal load which accounts for air temperature and humidity is therefore projected to increase significantly with climate change at a level of extreme danger.