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Mediterranean ecosystems are characterized by large arid areas where the patchy distribution of trees offers little protection against harsh climate conditions for seedling establishment. Climate change is predicted to result in an increase in these arid regions, with pronounced effects on vegetation. Production of seedlings with developed ectomycorrhizas is a promising strategy for minimizing the initial transplant shock, thereby increasing plant survival and growth during the first, most critical years of a plantation. One important species in the Mediterranean basin is Quercus suber (cork oak), which occurs, together with other evergreen oak species, in an agro-silvo-pastoral system that represents an example of sustainable land use in Europe. In this study, a Pisolithus tinctorius isolate was used for ectomycorrhizal colonization of cork oak nursery seedlings, and the effects on aboveground plant growth and leaf structural and physiological parameters were investigated. Ectomycorrhizal development resulted in a significant increase in leaf area, dry weight, nitrogen content, and photosynthetic pigments, and mycorrhizal plants showed a higher photosynthetic capacity and water use efficiency. Nursery-inoculated plants established in the field showed increased survival and growth during the first year after transplant. These results indicate a potential for further enhancing the use of mycorrhizal inoculation as a cultivation practice in forest nurseries. Considering the difficulty of soil restoration under limiting environmental conditions, nursery inoculation with ectomycorrhizal fungi can be an important advantage for improving the quality of seedling stock and its performance after out-planting in the field, benefiting the regeneration of arid regions and the reintroduction of inocula of ectomycorrhizal fungi into these areas. [ABSTRACT FROM AUTHOR]