West Nile virus (WNV) is transmitted to humans through infected Culex mosquito. It causes a sudden fever, but also, more rarely, neuroinvasive infections. Since its first identification in East Africa, the virus has been identified on all continents. The subject of this article was to review its spread in the Mediterranean basin until recently. It is very important for the implementation and development of control strategies to minimize risk of WNV emergence in the Mediterranean basin. Available data were used to assemble and synthesize information. West Nile virus has become endemic/enzootic in Eastern Europe and the Mediterranean basin. In other regions such as the South of France, Portugal and the Maghreb, the virus causes sporadic cases in both humans and equidae. Since 2010, there has been an increase in the number of cases, as well as an extent of the endemic area. The endemic area will probably increase in coming decades because of climate change, especially in the north and west, and thus reach previously unharmed areas.