Unexpected sudden catastrophic shifts may occur in ecosystems, with concomitant losses or gains of ecological and economic resources. Such shifts have been theoretically attributed to positive feedback and bistability of ecosystem states. However, verifications and predictive power with respect to catastrophic responses to a changing environment are lacking for spatially extensive ecosystems. This situation impedes management and recovery strategies for such ecosystems. Here, we review recent studies on various ecosystems that link self-organized patchiness to catastrophic shifts between ecosystem states.