Hot climates are typically marked by high temperatures, low rainfall, elevated salinity, and high humidity. These conditions accelerate the degradation of concrete, impacting its durability. In the Middle East, where a hot and humid climate prevails, several nuclear facilities, including those in hospitals, research centers, industries, and more recently, a nuclear power plant, are situated. In this updated review, the factors influencing the radiation shielding performance of concrete in arid climates are analyzed. The effects of high temperatures and chemical attacks, particularly sulfate attack, on shielding concrete are examined. The role of aggregate type and size, crucial for radiation attenuation, is also explored. Furthermore, commonly used additives and admixtures that enhance the attenuation coefficient of concrete are thoroughly reviewed. Methods for evaluating the radiation shielding properties of concrete, as reported in the literature, are discussed. Finally, case studies showcasing the application of radiation shielding concrete in extreme environmental conditions are highlighted. One major gap in existing research is the lack of comprehensive study on the effect of chemical attack on the shielding properties of concrete. As Middle Eastern countries, such as the UAE and Saudi Arabia, express interest in deploying nuclear energy, our goal is to present the first comprehensive article gathering all relevant information on the potential effects of the region's unique environmental conditions on the attenuation efficiency of concrete elements in such facilities.