Marine protected areas (MPAs) may be important for protecting the marine environment, but they may also have substantial socio-cultural impacts about which very little is currently known, or acknowledged. In the Mediterranean, few data are available on the socio-economic consequences of MPAs. The present study reviews the existing data on MPAs in Spain, France, Italy and Greece. A general increase in tourist activities in Mediterranean MPAs is evident, as are increases in the abundances of larger fish species, although there are no data indicating yields for fisheries increase adjacent to MPAs. A large increase in the number of divers and vessels using MPAs has already had impacts on natural benthic communities as a result of diver damage, mooring and the feeding of large fish by divers. Emphasis has been given in only a few MPAs to promoting public awareness of these impacts. Although the conservation of nature should be considered the fundamental objective of MPAs, neglecting their social, cultural and economic impacts has at times led to poor local consensus, if not hostility. We believe that planning and managing MPAs should be conducted on a multidisciplinary basis. Nonetheless, no single model can be considered valid for the whole Mediterranean. The very variable characteristics of coastal areas, from those of small uninhabited islands to those of cities, require different weightings to be assigned for each factor in order to achieve a durable equilibrium and realize the original objectives of each MPA. Only with such flexibility of management will it be possible to reach a greater understanding of the MPA system and create a lasting consensus in favour of conservation, a consensus which would mean an overwhelming majority of people actively avoiding damaging nature and preventing others from doing so.