Well-conserved herbarium specimens of marine macroalgae represent a valuable resource for multiple types of investigation. When algal herbaria host specimens collected over long time spans from a certain geographic area, they have the potential to document historical changes in the benthic vegetation of that area. In this study, historical changes in the macroalgal vegetation of a central Mediterranean coast (Conero Riviera, Adriatic Sea) were assessed based on a critical re-examination of the herbarium of Irma Pierpaoli (collection period 1925–1951) and the phycological herbarium of the Polytechnic University of Marche (ANC ALG, collections made mostly in the period 1999–2024). For both herbaria, the identifications of many specimens were revised based on the current species circumscriptions. The comparison indicates that some major changes occurred between the two collection periods: a switch in the morphological functional structure of the vegetation (increase in the number of filamentous species, decrease in leathery macrophytes, and the near disappearance of calcareous articulated algae), local extinction of some species (at least 23, possibly more), and introduction of 11 species of non-indigenous seaweeds. Anthropogenic impacts (habitat destruction, increase in sediment load, and impacts of port activities and maritime traffic) are considered the main factors responsible for these changes.