The Mediterranean is not only complex in ecology but also socio-politically and economically. The rapid economic development of the last decades is expected to further increase in the future, providing benefits for Mediterranean countries but also increasing pressure on coastal and marine environments and intensifying conflicts between different activities. This chapter illustrates the policy frame supporting Maritime Spatial Planning (MSP) implementation in the entire Mediterranean Sea. It discusses the importance of linking MSP with Integrated Coastal Zone Management (ICZM) given the high relevance of land-sea interactions. Although the process of MSP implementation is mainly at an initial stage in this sea basin, it can rely on broad-scale project-based experience. Examples of developed practices are provided in this chapter.