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Stream drying is happening globally, with important ecological and social consequences. Most examples of stream drying come from systems influenced by dam operations or those with highly exploited aquifers. Stream drying is also thought to be driven by anthropogenic climate change; however, examples are surprisingly limited. We explored flow trends from the five recognized Mediterranean‐climate regions of the world with a focus on unregulated (non‐dammed or non‐diverted) streams with long‐term gauge records. We found consistent evidence of decreasing discharge trends, increasing zero‐flow days, and steeper downward discharge trends in smaller basins. Beyond directional trends, many systems have recently undergone shifts in flow state, including some streams that have transitioned from perennial to intermittent flow states. Our analyses provide evidence of stream drying consistent with climate change but also highlight knowledge gaps and challenges in empirically and statistically documenting flow regime shifts. We discuss the myriad consequences of losing flow and propose strategies for improving detection of and adapting to flow change.