The present paper reviews the wastewater reuse regulations, practices and applications of countries around the Mediterranean Region, particularly focusing on reuse practices for municipal and industrial uses. Water scarcity and water need is established in Mediterranean countries using international indexes for a cross-border comparison of water availability specifically for fresh water supply for municipal and industrial applications. Wastewater reuse criteria based on necessary, application specific, treatment output quality are presented. Data for each individual country is reviewed, and the regulations governing each country around reuse and applications are summarized, focusing, when appropriate, on the production and use of reclaimed wastewater for municipal and industrial applications. Also a critical overview of the guidelines and regulations governing these countries is presented. After considering multiple parameters associated with adoption of municipal and industrial wastewater reuse, such as water supply and scarcity, country and regional parameters, as well as possible applications, we note that adoption is accelerated in countries that have stronger economies and higher water needs. This development is fueled by favorable guidelines and regulations; conversely it is hindered by prohibitive guidelines and regulations. Wastewater reuse for municipal and industrial applications so far remains a whimsical game of culture, perception, religion, available technology and politics. An increasing trend in wastewater treatment plant construction and planning is seen in almost all the countries of the Mediterranean region. In addition, reuse water standards are in the process of being developed in a way that will clearly take into account the local conditions while reasonably safeguarding the public health. Wastewater reuse for municipal and industrial applications in Mediterranean countries remains at the beginning stages of adoption and the potential for improvement is open.