Study regionMediterranean River Basins. Study focusHuman activities and consequent pollution have put the freshwater and marine ecosystems of the Mediterranean region under pressure, with high risk of eutrophication phenomena. In this study, an extended version of the Geospatial Regression Equation for European Nutrient losses model (GREEN), originally developed for estimating nutrient loads from diffuse and point sources in Europe, was extended to include additional nutrient sources using a grid cell discretization. The spatial resolution is 5 arc minute and the model inputs consist of the latest and best available global data. New hydrological insights for the regionThe results of this study show that during 2003–2007 (baseline), 1.87 Tg/y of total nitrogen (TN), 1.22 Tg/y of nitrates (N-NO3), 0.11 Tg/y of total phosphorus (TP) and 0.03 Tg/y of orthophosphate (P-PO4) were discharged in the Mediterranean Sea. The source apportionment analysis showed that the main contributor to total nitrogen and nitrate loads is agriculture followed by natural background, while for orthophosphate dominant sources include wastewater and scattered dwellings. Two scenarios were investigated to assess sustainable water and nutrient management options, showing that the reduction of 50% of nitrogen surplus leads to a significant reduction of nitrogen emission in regions characterized by high intensity agriculture, while the upgrading of wastewater treatment plants to tertiary level was more efficient for TP reduction.