Freshwater littoral zones harbor diverse ecological communities and serve numerous ecosystem functions that are controlled, in part, by natural water level fluctuations. However, human alteration of lake hydrologic regimes beyond natural fluctuations threaten littoral zone ecological integrity. One type of hydrologic alteration in lakes is winter water level drawdowns, which are frequently employed for hydropower, flood control, and macrophyte control, among other purposes. Here, we synthesize the abiotic and biotic responses to annual and novel winter water level drawdowns in littoral zones of lakes and reservoirs. The dewatering, freezing, and increased erosion of exposed lakebeds drive changes in the littoral zone. Shoreline-specific physicochemical conditions such as littoral slope and shoreline exposure further induce modifications. Loss of fine sediment decreases nutrient availability over time, but desiccation may promote a temporary nutrient pulse upon re-inundation. Annual winter drawdowns can decrease taxonomic richness of macrophytes and benthic invertebrates and shift assemblage composition to favor taxa with r-selected life history strategies and with functional traits resistant to direct and indirect drawdown effects. Fish assemblages, though less directly affected by winter drawdowns (except where there is critically low dissolved oxygen), experience negative effects via indirect pathways like decreased food resources and spawning habitat. We identify eight general research gaps to guide future research that could improve our understanding about the complex effects of winter drawdowns on littoral zone ecology.