This chapter discusses food value chains in the Mediterranean. Food value chains refer to all activities necessary to bring food from producers to consumers, including agriculture production, processing, storage, marketing, distribution, and consumption and the linkages between these actors, the flow of goods, and how stakeholders hare profitability. It is important that actors have a satisfaction out of their participation in the chain in four ways; they need to respect social and environmental sustainability, they need a further division of profitability, they need to share the value with stakeholders and know what the needs of stakeholders are, and they must take into account the challenges of the Med food value chains. Water scarcity deeply affects the Mediterranean food value chain. People also need to take into account changes in dietary choices. The imbalanced growth of population affects the value chain. The lack of integration between water, food, and energy is a critical issue in terms of environmental and social challenges. There is vertical fragmentation which disadvantages producers, or farmers, and a lack of horizontal integration, which means that there isn’t collaboration among different actors who work in the same sector. There is a lack of strong relationships with innovators, financial institutions, investors, and those who manage logistics support. Strategies are often based on cost reduction rather than on quality promotion and there is a lack of innovation. This chapter is part of Module 7: How to Achieve the Sustainable Development Goals (SDG) in the Mediterranean – The Way Forward III. Food Value Chain for Regional and Local Development.