The Mediterranean offers a unique opportunity to study the driving forces of tectonic deformation within a complex mobile belt. Lithospheric dynamics are affected by slab rollback and collision of two large, slowly moving plates, forcing fragments of continental and oceanic lithosphere to interact. This paper reviews the rich and growing set of constraints from geological reconstructions, geodetic data, and crustal and upper mantle heterogeneity imaged by structural seismology. We proceed to discuss a conceptual and quantitative framework for the causes of surface deformation. Exploring existing and newly developed tectonic and numerical geodynamic models, we illustrate the role of mantle convection on surface geology. A coherent picture emerges which can be outlined by two, almost symmetric, upper mantle convection cells. The downwellings are found in the center of the Mediterranean and are associated with the descent of the Tyrrhenian and the Hellenic slabs. During plate convergence, these slabs migrated backward with respect to the Eurasian upper plate, inducing a return flow of the asthenosphere from the back-arc regions toward the subduction zones. This flow can be found at large distance from the subduction zones and is at present expressed in two upwellings beneath Anatolia and eastern Iberia. This convection system provides an explanation for the general pattern of seismic anisotropy in the Mediterranean, first-order Anatolia, and Adria microplate kinematics and may contribute to the high elevation of scarcely deformed areas such as Anatolia and eastern Iberia. More generally, the Mediterranean is an illustration of how upper mantle, small-scale convection leads to intraplate deformation and complex plate boundary reconfiguration at the westernmost terminus of the Tethyan collision.