This report aims to identify priority pollution zones and emerging issues in the Mediterranean Sea. The report does not attempt to give an overall state of the Mediterranean marine environment. Instead it addresses specific issues which are of main concern to the sustainable development of the region: sewage and urban run-off; solid waste; industrial effluents including oil processing; urbanization; eutrophication; sand erosion; marine transport causing oil pollution; biological invasions; harmful algal blooms; exploitation of marine resources; expansion of aquaculture; natural hazards. The main problems in southern and eastern Mediterranean countries are the inadequate treatment of urban waste and management of chemicals in contrast to northern countries where efforts should be deployed to overcome the problems raised by use of chemicals and their impacts on environment. In the northern Mediterranean region, which is the most industrialised, there are a priori necessary prevention mechanisms, correction technologies and the appropriate legal framework. But there is a lack of political willingness from the countries to enforce environmental regulation. The southern Mediterranean region is growing at the expense of the environment since neither the economic conditions nor the required technologies are available. The number one priority in environmental management in the Mediterranean region is to develop the necessary environmental legislation and to enforce it.