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Marine beach litter (MBL) represents a serious issue for marine life, coastal ecosystems, human health and several economical activities. The Mediterranean Sea is a semi enclosed basin particularly vulnerable to this problem. Its coasts are threatened by critical anthropogenic pressures that sum up with intensive fishing and shipping, and the slow turnover of its waters. In the last decades, several scientific and participative initiatives have been conducted to study, monitor and clean-up shorelines. These studies were generally characterized by differences in timing and frequency of the surveys, as well as in litter sampling, classification and analysis. This paper presents a systematic review of current literature concerning MBL monitoring strategies along the Mediterranean coasts. Scopus indexed studies are analysed to identify discrepancies and similarities among the applied protocols, understand where current gaps lie, and point out what would be needed to develop a basin-scale efficient monitoring for the Mediterranean Sea.