This chapter discusses how the value chain can contribute to local and regional development. The Mediterranean diet consists of products that range from olive oil to fresh fruit and veggies to fish products. There is a north-south and east-west divide in the Mediterranean, as well as an urban and rural divide as cities become more populated. The food value chain is being affected by marketing trends and by phenomena like land grabbing and land grabbing. Participation or inclusion of smallholder farmers to help redistribute value is one of the best ways to improve the standard of living in regional and local development. The value chain is not just the vertical relationship between producers and consumers, its also a number of the relationships of the actors in the different rural regions. This chapter discusses how changing the horizontal and vertical relationships affects regional development. Value chain governance means the set of overall relationships that goes from producers to consumers with the value chain as the main unit of analysis. When looking at the small detail relationships in terms of buyers and sellers, the value chain is no longer the unit of analysis, instead the specific buyer and seller relationships are what we are observing and trying to understand. There is a level of cultural sensitivity to be understood with smallholder farmer, along with the more formal element of the transaction, which is the contractual obligation. There can also be costs that get in the way of participation in the value chain. There is an oft-forgotten social dimension to the Med food value chain.