Although Mediterranean is one of the world’s leading destinations, integrative studies on implementational aspects of sustainable tourism in the region have been scarce. One of the reasons is that sustainable tourism has been traditionally considered as the opposite of mass tourism which is the dominant form in Mediterranean coasts. This study attempts to assemble and conceptualize practices and policies used or proposed in different Mediterranean destinations with a focus on mass tourism. Issues which appear of importance to policy makers in the Mediterranean are discussed to explore relevance with the concept of sustainable tourism. In this way shortcomings as well as interrelations between different strategies are identified. The ultimate aim is to contribute to the establishment of a framework for sustainable tourism policies.