In recent years the Mediterranean has grown so markedly within the global cruise market that it now ranks second in the world. Demand growth rates are constantly positive. Supply is steadily growing; major world companies are deploying more vessels in the area; many passenger terminals and ports are undergoing infrastructural modernization. Overall, the entire Mediterranean cruise sector holds a far greater appeal than in the recent past. Vertical integration processes have played a major role in increasing the dynamism of the sector and in affecting the competition among ports. In this context, Barcelona and Civitavecchia have emerged as the top ranking ports. Continued growth in the Mediterranean market can be expected in the near future; the main challenges are continued terminal and service modernization, geopolitical stability, particularly in its central-eastern part, and effective marketing strategies integrating port activity with inland resources.