In the last 50 years, various parts of North Africa (NAF) have suffered devastating droughts, associated with high socio-economic impacts. This arid to semi-arid region is one of the most water-scarce areas in the world. In the context of water scarcity, many studies have focused on droughts approaching their impact from different disciplines and perspectives. However, more integrative studies covering both physical and social aspects are lacking for the region. The present study reviews drought's physical and human drivers, the associated socio-economic impacts in NAF countries, actual adaptation and management options. We summarize and intercompare management policies implemented by NAF governments to face the severity of such events. Our review highlights a contrasting vulnerability to droughts across the NAF countries, with relatively higher impacts in the western part. Studies show a lack of consistency about the observed increase in meteorological droughts severity and frequency in various regions of NAF. However, more consistent and slightly higher increases in agricultural drought intensity have been revealed, suggesting that the atmospheric evaporative demand due to the increased evapotranspiration has contributed to augmenting the severity of agricultural and ecological droughts compared to meteorological droughts. The North Atlantic Oscillation (NAO) is linked to dry and wet episodes in Northwest Africa from daily to centennial time scales. Changes in the planetary to the regional-scale circulation have been suggested to be responsible for the past and future projected drought increase. Other anthropogenic drivers, such as land use changes, increasing water demand and irrigation, strongly affect the severity of NAF droughts. The analysis of the historical events reveals extensive impacts on agriculture, employment, food security, health and internal migration. The adaptation strategies to drought include irrigation efficiency, groundwater overexploitation and the use of non-conventional water resources such as desalinated water. Various forms of drought monitoring and early warning operate on several institutional levels under the coordination of different institutions/ministries. An improved understanding of the characteristics of droughts and their impacts in NAF countries is important to guide the transition from emergency response to more proactive policies and long-term planning, but also to assess and identify gaps in drought management capacities.