This systematic review, based on an adaptation of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement from 2020, focuses on studies of the atmospheric mechanisms underlying extreme precipitation events in mainland Portugal, as well as observed trends and projections. The 54 selected articles cover the period from 2000 to 2024, in which the most used keywords are “portugal” and “extreme precipitation”. Of the 54, 23 analyse trends and climate projections of precipitation events, confirming a decrease in total annual precipitation, especially in autumn and spring, accompanied by an increase in the frequency and intensity of extreme precipitation events in autumn, spring and winter. Several articles (twelve) analyse the relationship between synoptic-scale circulation and heavy precipitation, using an atmospheric circulation types approach. Others (two) establish the link with teleconnection patterns, namely the North Atlantic Oscillation (NAO), and still others (three) explore the role of atmospheric rivers. Additionally, five articles focus on evaluating databases and Numerical Weather Prediction (NWP) models, and nine articles focus on precipitation-related extreme weather events, such as tornadoes, hail and lightning activity. Despite significant advances in the study of extreme precipitation events in Portugal, there is still a lack of studies on hourly or sub-hourly scales, which is critical to understanding mesoscale, short-lived events. Several studies show NWP models still have limitations in simulating extreme precipitation events, especially in complex orography areas. Therefore, a better understanding of such events is fundamental to promoting continuous improvements in operational weather forecasting and contributing to more reliable forecasts of such events in the future.