Climate change central and southern Iraq, for instance, has the rise of mean and minimum temperatures, changed precipitation regimes, more droughts, and extreme events with high intensity. Consequently, the ecological conditions that govern the population of Phlebotomus sandflies and disease transmission dynamics of both cutaneous and visceral leishmaniasis have also been affected. This review provides a summary of the latest evidence on the mechanistic pathways that connect climate drivers to the physiology of the sandfly, the formation of the microhabitat, the dynamics of the reservoir host, and the human exposure. Furthermore, it emphasizes how these processes, through land use change, water scarcity, and sociopolitical stressors, interact to create novel risk landscapes in Iraq's drought prone governorates. An increase in temperature not only shortens but can also lengthen the period during which the vector is active seasonally, while changing rainfall and irrigation practices produce varying microhabitats which either provide refugia or serve as breeding sites that are filled up by transients or pulses, producing strong populations through short periods. Heavy rainfall occurring now and then after a long dry period can lead to short population growth, while gradual drying favors the establishment of xerictolerance Phlebotomus species and the connection between them and humans living nearby. Different studies on regional spatiotemporal and nichemodelling analyses show that there might be changes in the distribution of species and their life cycles could be extended in a way that they invade human habitats with leishmaniasis where the reservoirs are present or become local transmission areas with visceral leishmaniasis. There are still major gaps in surveillance that are critical: there is very little long term species level entomology in central and southern Iraq; molecular diagnostics and sentinel networks are not developed at all; and integrated One Health strategies are applied only sometimes in the case of humanitarian or displaced population settings. The review concludes by giving upfront, operational priorities: in high risk microhabitats, set up sentinel entomological sites, make climate driven early warning indicators operational, increase moleculary species and parasite diagnostics, apply targeted One Health reservoir interventions, and test climate triggered response packages in high risk governorates. Coordinated research and policy action are urgent. Without such measures, ongoing warming and resource stress will increasingly favor vector persistence and localized leishmaniasis emergence in Iraq’s droughtprone heartlands.