Urbanization, a global process entailing profound socio-economic changes, transforms land cover. This review analyzes the social-ecological drivers and outcomes of land cover change (LCC) in five politically unstable regions: Greater Cairo, Tunisia, Lebanon, Syria, and the West Bank. Using data from 30 papers, we explored socio-political contexts and measured the social-ecological outcomes related to LCC. Remote sensing studies from 2011 to 2021 indicated predominantly negative social-ecological outcomes of urban expansion (p = 0.03), whereas, some studies indicated also positive outcomes of urban growth (p = 0.001). All studies highlighted the complex, location-specific interplay of LCC drivers. The lack of sufficient and consistent data to quantitatively assess the interlinkages between social-ecological outcomes and LCC drivers remains a challenge to better understand urbanization effects on ecosystem services.