Due to a lack of appropriate modelling tools, the atmospheric source mechanisms triggering the potentially destructive meteotsunami waves – occurring at periods from a few minutes to a few hours – have remained partially unstudied till recently. In this numerical work we thus investigate and quantify the impacts of orography and extreme climate changes on the generation and propagation of the atmospheric pressure disturbances occurring during six different historical meteotsunami events in the Adriatic Sea. Additionally, the impact of the bathymetry, and hence the Proudman resonance, on the propagation of the meteotsunami waves is also assessed for the same ensemble of events. Our main findings can be summarized as follow: (1) removing the mountains does not strongly affect the generation nor the propagation of the meteotsunamigenic disturbances but can slightly increase their intensity particularly over the land, (2) climate warming under extreme scenario has the potential to increase the intensity of both atmospheric disturbances and meteotsunami waves in the vicinity of the sensitive coastal areas while (3) flattening the bathymetry of the deepest Adriatic Sea tends to divert the meteotsunami waves from the sensitive harbour locations. Such sensitivity studies, if generalized to other geographical locations with a higher number of events, may provide new insights concerning the still unknown physics of the meteotsunami genesis and, consequently, help to better mitigate meteotsunami hazards worldwide.