This paper examines the characteristics of historical meteorological hazards and associated natural-anthropogenic variations in China, with specific attention given to the meteorological drought hazards occurring at very high frequency and affecting social–economic development in North China. Owing to an increasing awareness of meteorological droughts in this area, the aim of this contribution is to provide a comprehensive overview of meteorological droughts in North China by reviewing the meteorological references and their intrinsic linkages with climatic, geological, and anthropogenic controls. Our study highlights the region-wide meteorological droughts with a rather clear recurrence of 30 and 100 years, totally indicating Shanxi and Shandong being the predominated area suffering from extreme meteorological droughts. The spatial and temporal distribution of meteorological drought hazards in this region is considered to be a function of climatic, topographic, hydrological, and anthropogenic characteristics. In view of the wide distribution and linkage with geo-hazards and changes of dynasties, the meteorological drought hazard is one of the key issues for long-term social–economic harmonization. This study can be expected to prioritize drought mitigation measures and ensure regional sustainable development in North China.