Upper Miocene volcanic and plutonic rocks on Kos island preserve a record of magmatic and tectonic events in the transition zone between the Aegean and Anatolian microplates. Their field setting, syn-intrusion deformation, mineralogy, and geochemistry were investigated. Volcanic rocks, including trachyandesite flows and trachyandesite to rhyolite domes, were extruded on a central E–W horst and directly overlie Alpine basement. Thick successions of trachytic flow tuffs are interbedded with fluvial and lacustrine basinal sediments to the south of this horst. Volcanism was synchronous with the emplacement of the Dikeos monzonite pluton, which is geochemically similar to some lithic clasts in the thick flow tuffs and is cut by mafic dykes including lamprophyres. Two main types of mafic magma were present: a K-rich lamprophyric magma that evolved to trachyandesite and more calc-alkaline magma similar to mafic enclaves in the monzonite. Syn-intrusion structures in the monzonite indicate emplacement during E–W sinistral strike-slip faulting that created local transtensional deformation, providing accommodation for a Dikeos magma reservoir. A change in the style of deformation in the Late Miocene led to NW-striking extension in the footwall, occupied by mafic dykes and mineralized veins, and extensional detachment of the hanging wall, resulting in unroofing of the monzonite.