Heat and drought are two major environmental stresses that affect rice growth, productivity, and grain quality. a comprehensive understanding of which is critical to evaluate the impacts of climate change on crop production. We review the independent and combined effects of heat and drought on rice growth, yield, and grain quality, demonstrate the possible mechanisms involved from multiple perspectives, such as photosynthesis, antioxidant system, endogenous hormones, activities of the key enzymes involved in sucrose-to-starch conversion, and molecular profiling, proposes reasonable strategies to mitigate the stress of environmental heterogeneity, and provide considerable suggestions for future study.