The interaction of elevated [CO2] and water stress will have an effect on the adaptation of durum wheat to future climate scenarios. For the Mediterranean basin these scenarios include the rising occurrence of water stress during the first part of the crop cycle. In this study, we evaluated the interactive effects of elevated [CO2] and moderate to severe water stress during the first part of the growth cycle on physiological traits and gene expression in four modern durum wheat genotypes. Physiological data showed that elevated [CO2] promoted plant growth but reduced N content. This was related to a down-regulation of Rubisco and N assimilation genes and up-regulation of genes that take part in C-N remobilization, which might suggest a higher N efficiency. Water restriction limited the stimulation of plant biomass under elevated [CO2], especially at severe water stress, while stomatal conductance and carbon isotope signature revealed a water saving strategy. Transcript profiles under water stress suggested an inhibition of primary C fixation and N assimilation. Nevertheless, the interactive effects of elevated [CO2] and water stress depended on the genotype and the severity of the water stress, especially for the expression of drought stress-responsive genes such as dehydrins, catalase, and superoxide dismutase. The network analysis of physiological traits and transcript levels showed coordinated shifts between both categories of parameters and between C and N metabolism at the transcript level, indicating potential genes and traits that could be used as markers for early vigor in durum wheat under future climate change scenarios. Overall the results showed that greater plant growth was linked to an increase in N content and expression of N metabolism-related genes and down-regulation of genes related to the antioxidant system. The combination of elevated [CO2] and severe water stress was highly dependent on the genotypic variability, suggesting specific genotypic adaptation strategies to environmental conditions.