Marine litter is human-created waste that has been discharged into the coastal or marine environment. "Marine debris" is defined as anthropogenic, manufactured, or processed solid material discarded, disposed of, or abandoned in the environment, including all materials discarded into the sea, on the shore, or brought indirectly to the sea by rivers, sewage, storm water, waves, or winds. A large fraction of marine debris is made up of plastic items. Plastic marine debris has become one of the most prevalent pollution related problems affecting the marine environment globally. The widespread challenge of managing marine litter is a useful illustration of the global and transboundary nature of many marine environmental problems. At a global level, plastic litter constitutes 83-87% of all marine litter. Land-based sources are estimated to be responsible for approximately 80% of marine litter. The largest portion of plastic associated with marine pollution is often linked to the contribution from terrestrial sources associated with accidental or deliberate spills as well as inefficient waste management systems in heavily anthropized coastal regions. This chapter is intended to serve as a catalyst for further discussion to explore the potential for developing a Mediterranean regional framework for addressing marine litter.