Protected cultivation includes different types of structures protecting the plants from harsh environmental conditions, extending the cultivation season, and or providing out-of-season crop production. Although commercially protected cultivations developed broadly after the 2nd World War by using heated glasshouses, the history is shorter for the Mediterranean region. The expansion of protected cultivation was in the 1960s by the introduction of plastics into agriculture. During the 1970s the rise in oil prices enhanced protected cultivation in this region due to mild winter climate conditions that made the production possible under very simple shelters. Since then, the Mediterranean region has gained more and more importance, representing now one of the most important areas in the world. Protected cultivation shows significant differences between the countries located in different climate zones. More sophisticated structures and advanced technology are used with extended environmental control in the higher latitudes, whereas lower investment, simpler design, low-tech and low-cost structures, less climate control characterize protected cultivation in the Mediterranean Region. However, increasing attention of the consumers concerning the quality of the product and the sustainability of the production process has resulted in the development of sustainable production systems and improved structures during the last two decades. In this paper, the present situation of the protected cultivation industry in the Mediterranean region, advantages and constraints (water availability, salinity, etc.), and recent trends and developments on sustainable technologies (certified production technologies, energy use, etc.) during the last two decades is discussed. © 2021 International Society for Horticultural Science. All rights reserved.