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The Mediterranean basin is one of the most vulnerable regions worldwide due to its population density, the concentration of economic activities along the coasts and borderline climatic balance. It is identified as one of the most critical erosion hotspots in Europe, mainly due to the degradation of coastal areas, overexploitation and unsustainable practices affecting beach tourism, agriculture and fishing. The region is also affected by other phenomena such as storms and floods, which are exacerbated by climate change. To mitigate and adapt to these environmental and climatic changes, Nature based Solutions (NbSs) are considered a promising step-forward. However, despite their global recognition in both research and policy, few scientific papers and documents on the state of NbSs implementation for coastal risk management in the Mediterranean exist. This paper aims to provide an understanding of the status of NbS adoption for coastal risk management in the Mediterranean through a literature review. Out of 162 scientific papers and documents, only 23 were found to be relevant to the study. Through the definition and support of an innovative matrix-based approach, the analysis of the state of adoption of NbSs have been performed. Despite the limited information on the state of the adoption of NbSs for coastal risk management in the Mediterranean due to the low numbers of scientific research and documents available, some key considerations have been revealed. • The Mediterranean basin is the most critical erosion hotspots in Europe. • NbSs are recognized a promising step-forward in coastal risk management. • Novel framework for the analysis of past and present NbS implementation. • Few studies report the adoption of NbSs for Mediterranean coastal risk management. • NbS for coastal risk management in the Mediterranean is still in an experimental phase. [ABSTRACT FROM AUTHOR]