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Cucurbits are among the most cultivated crops, and the most economically important species are melon (Cucumis melo L.), cucumber (Cucumis sativus L.), watermelon (Citrullus lanatus Thumb.), squash (Cucurbita pepo L.), and pumpkin (Cucurbita spp.). These crops have become important income sources providing export and local consumption commodities in many Mediterranean countries. Increased area of cucurbits has led to the emergence of several viral diseases, which can have impacts on crop production and threaten agricultural sustainability. An overview of the most damaging cucurbit viruses in the Mediterranean area is provided to improve understanding of the diseases they cause and to emphasize effective disease management strategies. An updating of the geographical distribution of these viruses, the symptoms they cause and their means of transmission is also provided. Disease management methods and measures by farmers and phytosanitary authorities to address the virus outbreaks are outlined, including diagnostics, use of tolerant cultivars, and chemical and biological vector control. Mediterranean region farmers have learned many lessons from the damaging pandemics caused by cucurbit viruses, through the extensive published research, and this review provides a basis for managing future outbreaks of newly emerging virus infections.