Climate change is having a significant impact on ecosystem services and is likely to become increasingly important as this phenomenon intensifies. Future impacts can be difficult to assess as they often involve long timescales, dynamic systems with high uncertainties, and are typically confounded by other drivers of change. Despite a growing literature on climate change impacts on ecosystem services, no quantitative syntheses exist. Hence, we lack an overarching understanding of the impacts of climate change, how they are being assessed, and the extent to which other drivers, uncertainties, and decision making are incorporated. To address this, we systematically reviewed the peer‐reviewed literature that assesses climate change impacts on ecosystem services at subglobal scales. We found that the impact of climate change on most types of services was predominantly negative (59% negative, 24% mixed, 4% neutral, 13% positive), but varied across services, drivers, and assessment methods. Although uncertainty was usually incorporated, there were substantial gaps in the sources of uncertainty included, along with the methods used to incorporate them. We found that relatively few studies integrated decision making, and even fewer studies aimed to identify solutions that were robust to uncertainty. For management or policy to ensure the delivery of ecosystem services, integrated approaches that incorporate multiple drivers of change and account for multiple sources of uncertainty are needed. This is undoubtedly a challenging task, but ignoring these complexities can result in misleading assessments of the impacts of climate change, suboptimal management outcomes, and the inefficient allocation of resources for climate adaptation.