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Our paper reviews recent progress in the study and understanding of observed trends in extreme rainfall events in the Metropolitan Area of São Paulo (MASP). These are discussed in relation to hydrometeorological hazards that trigger natural disasters, such as flash floods, landslides, and droughts, that affect the population and local economies. A review of the most updated literature on rainfall and extremes in the MASP shows a significant increase in the total volume of rainy-season rainfall during the last seven decades. While there were practically no days with heavy rain (more than 50 mm) in the 1950s, these days have been occurring two to five times a year in the last 10 years. This, together with the inappropriate occupation of risky areas, such as slopes and banks of watercourses, leads to inundation, flooding, and landslides. Changes in extremes can be partly due to natural climate variability but can also be related to global warming and/or urbanization. There is ample evidence of an increasing risk of rainfall-related hazards in theMASP. This is particularly so for landslides in vulnerable areas. Exposure will continue to lead to risk increases. This calls for significant improvement in climate and disaster risk reduction and management efforts in theMASP region. [ABSTRACT FROM AUTHOR]