Hydro-climatic extremes, such as droughts and floods, have most likely increased due to climatic change and could lead to severe impacts on socio-economic, structural and environmental sectors. With nearly 4000 publi- cations, the Soil and Water Assessment Tool (SWAT) is clearly one of the most extensively used ecohydrological models worldwide. The model has been widely used for projecting the impacts of future hydro-climatic changes, but application for extreme streamflow conditions is still rarely reported. To date, SWAT application reviews have focused on compilations of SWAT studies for specific or relatively new applications such as eco-hydrological mod- elling, ecosystem services, sub-daily simulations, and pesticide fate and transport simulations. However, no exist- ing SWAT review studies have focused on simulation of hydro-climatic extremes. Therefore, this research aims to bridge this gap by compiling and reviewing the findings of studies reporting SWAT hydro-climatic extremes in- cluding highlighting the performance and future research needs. A total of 111 articles have been identified since 1999; most of these studies were conducted in the United States and China. These articles can be divided into extreme flow assessments, drought studies, flood studies, drought and flood studies, SWAT coupling with other models, and SWAT improvements. Most of the extreme performance assessment studies reported “satisfactory ”performance, with a particular emphasis on peak flow comparisons. Future research needs regarding this topic include: (1) a unified SWAT extreme performance assessment framework; (2) SWAT improvements that result in improved replication of peak and low flows; (3) reliability assessment of global and satellite products for SWAT extreme simulations; (4) bias correction of CMIP6 and regional climate projections; (5) comparison of SWAT + and SWAT for extreme flow simulations in different types of basins; (6) development of an extreme flow module within an overall SWAT modelling system; and (7) integration of artificial intelligence within SWAT modelling.