Drought is an inevitable condition with negative impacts in the agricultural and climatic sectors, especially in developing countries. This study attempts to examine the spatial and temporal characteristics of drought and its trends in the Koshi River Basin (KRB) in Nepal, using the standardized precipitation evapotranspiration index (SPEI) over the period from 1987 to 2017. The Mann-Kendall test was used to explore the trends of the SPEI values. The study illustrated the increasing annual and seasonal drought trends in the KRB over the study period. Spatially, the hill region of the KRB showed substantial increasing drought trends at the annual and seasonal scales, especially in summer and winter. The mountain region also showed a significant increasing drought trend in winter. The drought characteristic analysis indicated that the maximum duration, intensity, and severity of drought events were observed in the KRB after 2000. The Terai region presented the highest drought frequency and intensity, while the hill region presented the longest maximum drought duration. Moreover, the spatial extent of drought showed a significant increasing trend in the hill region at the monthly (drought station proportion of 7.6%/10a in August), seasonal (drought station proportion of 7.2%/10a in summer), and annual (drought station proportion of 6.7%/10a) scales. The findings of this study can assist local governments, planners, and project implementers in understanding drought and developing appropriate mitigation strategies to cope with its impacts.