Abstract Considering its specific economic, social, environmental and political features, the status and evolution of the Mediterranean have always been of great interest to its countries and concerned partners. From the protection of the sea against pollution, the interest was progressively expanded to land based development and its impacts on environment, to coastal management and finally to sustainable development with the establishment of the Mediterranean Commission on Sustainable Development (MCSD). Cumulated knowledge, coupled with political support and commitment to a common vision, has prepared the ground for the preparation of a regional strategy for sustainable development. Its preparatory process, coordinated by the MCSD Secretariat, has been very interactive, involving various stakeholders. The strategy, adopted in 2005, has raised awareness and induced the preparation of national sustainable development strategies.