The Mediterranean is experiencing a number of immediate coastal problems which are triggering efforts to improve short-term coastal management. This paper shows that coastal management also needs to address long-term problems and, in particular, the likelihood of climate change. Regional scale studies suggest that the Mediterranean is particularly vulnerable to increased flooding by storm surges as sea levels rise -a 1 m rise in sea level would cause at least a six-fold increase in the number of people experiencing such flooding in a typical year, without considering population growth. Protection is quite feasible, however, this would place a greater burden on those Mediterranean countries in the south than those in the north. All coastal wetlands appear threatened. Case studies of coastal cities (Venice and Alexandria), deltas (Nile, PO, Rhone and Ebro), and islands (Cyprus) support the need to consider climate change in coastal planning. However, the critical issues vary from site to site and from setting to setting. In deltaic areas and low-lying coastal plains climate change, particularly sea-level rise, is already considered as an important issue, but elsewhere this is not the case. Therefore, there is a need for coastal management plans to explicitly address long-term issues, including climate change, and integrate this planning with short-term issues. This is entirely consistent with existing guidelines. Given the large uncertainty concerning the future, planning for climate change will involve identifying and implementing low-cost proactive measures, such as appropriate land use planning or improved design standards incorporated within renewal cycles, as well as identifying sectors or activities which may be compromised by likely climate change. In the latter case, any necessary investment can be seen as a prudent 'insurance policy'.