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Mediterranean islands (MI) are hotspots of global biodiversity and lie in one of the most susceptible to climate change (CC) areas of the world; a big challenge for any conservation strategy. In fact, there is already increasing evidence for CC in the region and associated biological responses in MI ecosystems. These include phenological changes and upward elevation shifts of species and plant communities; although evidence is frequently contrasting for different taxa. Threats are also evident, mainly for endemic species from most taxonomic groups, while communities in mountain and coastal regions are likely to be affected most. For MI conservation under CC additional factors need to be considered: (i) their position at the crossroads of three continents; with which they share common environmental characteristics, (ii) their great variability in sizes and topography and (iii) their climatic differences; with a …