Carbonate rocks in the Mediterranean region form karst landscapes with a variety of morphological and hydrological features, and are of particular interest from a water management perspective as they represent major karst aquifers. The Mediterranean Karst Aquifer Map and Database (MEDKAM) provides a 1:5,000,000 scale map showing the distribution of carbonate and evaporite rocks that can host karst groundwater resources, with additional information on other hydrogeological settings, selected terrestrial and submarine karst springs, caves and karst groundwater-dependent ecosystems. A statistical evaluation shows that carbonate rocks cover ~39.5% of the Mediterranean region within a 250-km focus area from the coastline. North Africa has the largest continuous area of carbonate rocks, while smaller countries in the Middle East and the Dinarides have the largest proportion of carbonate rocks in relation to their total area. Carbonate rocks are also widespread in coastal areas, occurring along ~33.6% (14,000 km) of the total Mediterranean coastline, including large islands such as Crete and Mallorca, and ~25.9% (6,400 km) of the continental coastline. Two additional maps display (1) groundwater recharge, showing a climatic gradient from north to south, and (2) groundwater storage trends, indicating a mean annual karst groundwater loss from 2003 to 2020 of 436 million m3 in the 250-km area. This study quantifies the carbonate rocks in the Mediterranean region and shows their importance for groundwater resources. MEDKAM will serve as a basis for further research and improved international cooperation in karst groundwater management.