Higher precipitation is expected over most of the world’s continents under climate change, except for a few specific regions where models project robust declines. Among these, the Mediterranean stands out as a result of the magnitude and significance of its winter precipitation decline. Locally, up to 40% of winter precipitation could be lost, setting strong limits on water resources that will constrain the ability of the region to develop and grow food, affecting millions of already water-stressed people and threatening the stability of this tense and complex area. To this day, however, a theory explaining the special nature of this region as a climate change hot spot is still lacking. Regional circulation changes, dominated by the development of a strong anomalous ridge, are thought to drive the winter precipitation decline, but their origins and potential contributions to regional hydroclimate change remain elusive. Here, we show how wintertime Mediterranean circulation trends can be seen as the combined response to two independent forcings: robust changes in large-scale, upper-tropospheric flow and the reduction in the regional land–sea temperature gradient that is characteristic of this region. In addition, we discuss how the circulation change can account for the magnitude and spatial structure of the drying. Our findings pave the way for better understanding and improved modeling of the future Mediterranean hydroclimate.