Medicanes or “Mediterranean hurricanes” are extreme cyclonic windstorms morphologically and physically similar to tropical cyclones. Owing to their potential destructiveness on the islands and continental coastal zones, medicane risk assessment is of paramount importance. With an average frequency of only one to two events per year and given the lack of systematic, multidecadal databases, an objective evaluation of the long-term risk of medicane-induced winds is impractical with standard methods. Also, there is increasing concern about the way these extreme phenomena could change in frequency or intensity as a result of human influences on climate. Here we apply a statistical-deterministic approach that entails the generation of thousands of synthetic storms, thus enabling a statistically robust assessment of the current and future risk. Fewer medicanes but a higher number of violent storms are projected at the end of the century compared to present, suggesting an increased probability of major economic and social impacts as the century progresses.