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(1) Background: Climate change and inequality are topics of major interest in Mediterranean Archaeology. However, comparatively less attention has been dedicated to how these themes are interlinked in the literature. No scoping review has ever addressed this issue. This study aims to identify major research trends on inequality and climate change in the Mediterranean c. 4000 BC–AD 500. It also pinpoints current research gaps on the topic and nascent areas of enquiry. (2) Method: We performed a scoping review on JSTOR, Scopus, Google Scholar and PubMed in December 2025–January 2026. A modified version of the PRISMA-ScR protocol was followed. We sampled journal articles, book chapters, edited volumes and monographs published between 2015 and 2025 which matched the search and inclusion criteria. Additional searches were done on Google Scholar in February 2026 to expand upon emerging research trends relevant to our topic but largely absent from the scoping review. We manually extracted, charted, analysed and synthesised the data. (3) Results: A total of 154 studies were eligible for the scoping review. We identified six research trends prominent in the sampled literature: 1. the rise and fall of world systems, macroscale causal links, and collapse research; 2. inequality, subalternity, and marginality; 3. agriculture, crops, and diet; 4. natural resource management, and water supply; 5. epistemology and methodology; and 6. natural archives and climate proxy datasets. We also recognised the following research gaps or topics that were comparatively less addressed: collapse research applied to the microscale level and marginalised communities; isotope analysis applied to both climate change and inequality in the same study; biomedical approaches applied to both climate change and inequality in the same study; social marginality as a complex construct in human–climate interactions; and the environmental and climate dimensions of the early Roman expansion, especially regarding marginality and the microscale. Finally, we identified artificial intelligence (AI), Big Data, environmental and climate activism, and the perception of climate hazards by subaltern communities as nascent topics of interest that might rise to prominence in the future. (4) Conclusions: We identified major research trends and gaps on climate change and inequality in the ancient Mediterranean in literature published 2015–2025. We also recognised nascent or unexplored topics. The review is intended as a benchmark for developing novel research on the cutting-edge of Mediterranean Archaeology.