Floods in the Venice city centre result from the superposition of several factors: astronomical tides; seiches; and atmospherically forced fluctuations, which include storm surges, meteotsunamis, and surges caused by atmospheric planetary waves. All these factors can contribute to positive water height anomalies individually and can increase the probability of extreme events when they act constructively. The largest extreme water heights are mostly caused by the storm surges produced by the sirocco winds, leading to a characteristic seasonal cycle, with the largest and most frequent events occurring from November to March. Storm surges can be produced by cyclones whose centres are located either north or south of the Alps. Historically, the most intense events have been produced by cyclogenesis in the western Mediterranean, to the west of the main cyclogenetic area of the Mediterranean region in the Gulf of Genoa. Only a small fraction of the inter-annual variability in extreme water heights is described by fluctuations in the dominant patterns of atmospheric circulation variability over the Euro-Atlantic sector. Therefore, decadal fluctuations in water height extremes remain largely unexplained. In particular, the effect of the 11-year solar cycle does not appear to be steadily present if more than 100 years of observations are considered. The historic increase in the frequency of floods since the mid-19th century is explained by relative mean sea level rise. Analogously, future regional relative mean sea level rise will be the most important driver of increasing duration and intensity of Venice floods through this century, overcompensating for the small projected decrease in marine storminess. The future increase in extreme water heights covers a wide range, largely reflecting the highly uncertain mass contributions to future mean sea level rise from the melting of Antarctica and Greenland ice sheets, especially towards the end of the century. For a high-emission scenario (RCP8.5), the magnitude of 1-in-100-year water height values at the northern Adriatic coast is projected to increase by 26–35 cm by 2050 and by 53–171 cm by 2100 with respect to the present value and is subject to continued increase thereafter. For a moderate-emission scenario (RCP4.5), these values are 12–17 cm by 2050 and 24–56 cm by 2100. Local subsidence (which is not included in these estimates) will further contribute to the future increase in extreme water heights. This analysis shows the need for adaptive long-term planning of coastal defences using flexible solutions that are appropriate across the large range of plausible future water height extremes.