Rice-based food production is crucial for food security, socio-political stability, and economic development in Bangladesh. However, climate and environmental changes pose serious challenges to sustainable rice production in the country. This review paper critically reviews the status, challenges, and adaptation opportunities of Bangladeshi rice systems in changing environmental, demographic, and socio-economic settings. A mixed-methods approach (quantitative summary of secondary data on rice production, environmental changes, impact on rice productivity; and qualitative thematic synthesis) was used to review adaptation for resilient rice production. Significant agronomic and environmental challenges to rice-based cropping in Bangladesh are posed by rising temperatures, anomalous rainfall patterns, extreme weather, and increasing salinisation. Rice production, availability, and access have been further compromised by decreasing arable areas, labour shortages, crop diversification, and low profitability. Farmers are adapting through autonomous and centrally planned strategies such as efficient irrigation and input use, stress-tolerant cultivars, mechanisation, and income diversification. However, profitable and sustainable adaptation requires broader facilitation by the government (e.g., infrastructure, financial incentives) and agribusiness (e.g., extension services, contracting). This review paper recommends research and development support for efficient irrigation management and stress-tolerant cultivars, enabling policy initiatives, and equitable value chain participation. The insights of the review can be applied to policymakers to target policy design and decision-making for a sustainable rice system in years to come.