Climate change has been recognised as a major concern in coastal hotspots exposed to multiple climate hazards under regionally specific characteristics of vulnerability. We review the emerging research and current trends in the academic literature on coastal climate risk and adaptation from a human security perspective. The ecological and socioeconomic developments are analysed for key risk areas, including coastal infrastructure; water, food and fisheries; health; human mobility; and conflict, taking the different geographical contexts of coastal areas in islands, megacities and deltas into consideration. Compounding and cascading interactions require integrative research and policy approaches to address the growing complexity. Governance mechanisms focus on coastal management and adaptation, nature-based solutions and community-based adaptation, considering their synergies and trade-offs. This perspective allows for a holistic view on climate risks to human security and vicious circles of societal instability in coastal systems and the interconnectedness of different risk dimensions and systems necessary for sustainable and transformative adaptation solutions for the most affected coastal hotspots.