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Predicting sets of outcomes—instead of unique outcomes—is a promising solution to uncertainty quantification in statistical learning. Despite a rich literature on constructing prediction sets with statistical guarantees, adapting to unknown covariate shift—a prevalent issue in practice—poses a serious unsolved challenge. In this article, we show that prediction sets with finite-sample coverage guarantee are uninformative and propose a novel flexible distribution-free method, PredSet-1Step, to efficiently construct prediction sets with an asymptotic coverage guarantee under unknown covariate shift. We formally show that our method is asymptotically probably approximately correct, having well-calibrated coverage error with high confidence for large samples. We illustrate that it achieves nominal coverage in a number of experiments and a data set concerning HIV risk prediction in a South African cohort study. Our theory hinges on a new bound for the convergence rate of the coverage of Wald confidence intervals based on general asymptotically linear estimators.