Climate change is intensifying the frequency and severity of weather- and climate-related hazards worldwide, with Southern Africa experiencing particularly acute and unevenly distributed impacts. Despite contributing minimally to global greenhouse gas emissions, countries in the region face escalating burdens, including food and water insecurity, health system strain, and climate-induced displacement. Adolescents and young people are disproportionately affected, as climate shocks intersect with developmental, socioeconomic and structural inequalities, increasing risk to health, sexual and reproductive health and rights (SRHR), education and gender equality. Yet these intersections remain underexplored in climate research and policy. Using an adapted socio-ecological framework that combines Bronfenbrenner’s model with the WHO operational framework for climate-resilient health systems, this study analyses climate change as a systemic disruptor that amplifies existing inequalities related to SRHR, gender and education in Malawi, Mozambique, and Zambia. From a youth-centred, we combine a targeted literature and policy review with six sense-making and validation workshops, involving 88 youth advocates, and 15 semi-structured expert interviews. This design generates context-specific, stakeholder-validated evidence on cumulative climate impacts and implementation gaps across sectors. Findings show that climate-related disruptions to infrastructure, services and livelihoods compound pre-existing vulnerabilities, undermining access to SRHR services and education, reinforcing gendered risks and intensifying exclusion among marginalised youth. Climate change is increasing the risk of key SRHR issues, such as early marriage and teenage pregnancy, fragilizing education systems and opportunities with disrupted learning environments and increasing levels of gender-based, child violence and mental health concerns. Climate impacts on adolescents and young people are cumulative and mutually reinforcing, requiring coordinated, intersectoral and gender-transformative responses rather than fragmented, short-term interventions. Meaningful participation of adolescents and young people emerges as both a rights-based obligation and a practical condition for effective and equitable climate action.