The different components of the Mediterranean Basin (land, coast, and sea) are undergoing significant changes due to multiple anthropogenic pressures, including climate change, pollution and other factors. The 1 st Mediterranean Assessment Report (MAR1), produced by the Mediterranean Experts on Climate and environmental Change (MedECC) and based on available scientific literature, provides a coherent and comprehensive synthesis of the status of the Mediterranean Basin, its main drivers and their impacts on both ecosystems and human dimensions, with a focus on water, food, energy, ecosystems and ecosystem services, development, health and human security. The report is the first multidisciplinary, trans-boundary assessment produced for this region and provides significant input to inform policy at regional, national and local levels. Its groundbreaking nature lies in the scope of the scientific assessment as well as in displaying the regional capacity to coordinate existing fragmented efforts in the region. The report highlights risks and possible response strategies that may help to increase the resilience to the effects of climate and environmental change. The conclusions show that effective policy responses, as well as in support of Sustainable Development Goals, encompass both strengthened mitigation of climate and environmental change and enhanced adaptation to their impacts. Socioeconomic factors of poverty, inequalities and gender imbalances presently hamper the achievement of sustainable development and climate resilience in Mediterranean countries.