Karst aquifers constitute important freshwater resources, but are challenging to manage and to protect, because of their unique hydraulic structure and behaviour, representing continuous challenges for research and development. Karst aquifers are widespread and contribute to freshwater supply of most Mediterranean countries and many cities are supplied by karst water, e.g., Rome, Vienna, Montpellier and Beirut. These land surfaces correspond to the main recharge zones of karst aquifers, which are often hydraulically connected over large areas and are highly vulnerable to contamination. The preparation of the Mediterranean Karst Aquifer Map (MEDKAM) generally followed the workflow used for the World Karst Aquifer Map (WOKAM). A new lithological classification has been developed for the MEDKAM, similar to that of the WOKAM, which groups the geological units into four meaningful hydrogeological units: 1). Karst aquifers in sedimentary and metamorphic carbonate rocks. 2). Karst aquifers in evaporite rocks. 3). Various hydrogeological settings in other sedimentary and volcanic formations (karst aquifers are possibly present at depth). 4). Local, poor and shallow aquifers in other metamorphic rocks and igneous rocks (no karst aquifers present at depth).