Global warming has accelerated the interregional hydrological cycle, resulting in a significant increase in the frequency and intensity of extreme events worldwide. These events often involve a combination of spatial and temporal factors, giving rise to compound events. Among them are rapid transitions from dry and hot conditions to wet (DHW) events, which can have more severe impacts on human societies and ecosystems than individual extreme events. Urbanization not only heightens the likelihood of disasters but also exacerbates the exposure of affected populations. However, there has been insufficient attention given to understanding the connections between these successive compound events and the heightened risks posed by the increasing urbanization. In this study, we used bias-corrected daily precipitation and maximum temperature data simulated by the Coupled Model Intercomparison Project Phase 6 (CMIP6) model, along with historical and future daily runoff data simulated by the Variable Infiltration Capacity (VIC) model. We systematically investigated the spatiotemporal changes (i.e., frequency, duration, intensity, and compound probability) in DHW events in China during the upper historical period (1979–2014) and under two medium and high emission scenarios (2015–2100) − Shared Socioeconomic Pathways (SSP245 and SSP585). Furthermore, we examined how extreme runoff responds to variations in maximum temperature and daily precipitation during DHW events. We also evaluated the potential population and urban exposure to DHW events using dynamic future population and urban expansion data to assess the potential risks. Our results indicate that the multi-model ensemble predicts varying spatial patterns of future DHW events under SSP245 and SSP585 scenarios. The frequency and duration of these events are expected to decrease by approximately 20–25% in the Northwest region under both scenarios. At the same time, the middle and lower plains of the Yangtze and Yellow River Basins experience increased occurrence, broader geographical impact, and higher DHW event intensity alongside urban expansion and population growth in these regions. Specifically, event intensity is anticipated to increase by a factor of approximately 7–11. Temporally, we expect short-duration, high-intensity DHW events to occur in the Yangtze and Yellow River basins around 2023, 2038, and 2058, respectively. The primary driver for the future rise in population exposure to DHW events is the expected increase in event frequency in the middle and lower plains of the Yangtze and Yellow River basins, concurrent with population growth in these regions. Under the medium emission scenario, the total exposed population to DHW events in China is predicted to be 1.61 times higher than the historical baseline. In contrast, the high-emission scenario estimates a total population of 2.41 times higher than the historical baseline period. Most of the DHW events occurred in regions that exhibit a positive dependence between high temperature and high runoff events, serving as the primary driver of DHW events. Urbanization has a positive impact on DHW events, with the effect under high emissions being approximately 30% higher than during the historical base period. Additionally, it is indicated that future DHW events will exhibit higher sensitivity to global warming, with intensity projected to increase approximately fourfold and the exposed population to rise by about 1.5 times for every 1 °C of global warming. This research enhances our understanding of forecasting future compound hydrometeorological extreme events under different scenarios and provides insight into the role of climate change and urbanization in shaping these events in China.