In light of the increasing demand for sustainable development, the agri-food industry is under pressure to make the transition towards sustainability. Innovation has been identified as a key driver for this transformation. However, the agri-food industry, which in many countries is dominated by small and medium-sized enterprises, is highly sensitive to the benefits, costs and potential risks of sustainability-oriented innovation. At the same time, because of the low propensity of countries in the Mediterranean region to innovate, an in-depth exploration of innovation is necessary. This paper presents a review of the costs and benefits of specific sustainability-oriented innovations, not only economic but also social and environmental, to provide a guide for researchers and adopters of sustainability-oriented innovations in the Mediterranean region. To achieve this goal, this paper classifies the elements being reviewed according to the nature of the innovation and stages of the product life cycle it covers. This paper has implications for farmers, business managers, regulators and policy makers in the Mediterranean region.