The acceleration of global warming and increased vulnerability of marine social-ecological systems affect the benefits provided by the ocean. Spatial planning of marine areas is vital to balance multiple human demands and ensure a healthy ocean, while supporting global ocean goals. To thrive in a changing ocean though, marine spatial planning (MSP) must effectively integrate climate change. By reviewing existing literature on MSP and climate change, we explore the links between them and with ocean sustainability, highlight management challenges, and identify potential pathways to guide action towards the effective integration of climate impacts in MSP.