This review provides an overview of the Mediterranean diversity and conservation status of cetaceans, and the value associated with their conservation and non-consumptive use. Mediterranean Sea is one of the world's diversity hotspots. Its biodiversity is increasingly under threat in the whole region and key species as cetaceans challenge for conservation. All the identified threats are interlinked and cumulatively contribute to the habitat degradation of the entire area as well as reduced health status of the cetaceans that live there. Whales and dolphins, defined as charismatic megafauna, flag species, apex predators and bio indicators of the marine environment health are demanding social substantial changes. Needs are for spatial prioritization within a comprehensive framework for regional conservation planning, the acquisition of additional information identifying critical habitats in data-poor areas and for data deficient species, and addressing the challenges of establishing transboundary governance and collaboration in socially, culturally and politically complex conditions. This paper examines research gaps, questions and issues (population abundance estimates, as well as the biological, ecological, physiological characteristics) surrounding cetacean species in the context of biodiversity conservation and highlights the need of targeted conservation management actions to reduce sources of disturb of key threatening processes in the Mediterranean Sea. The 'precautionary principle' must be adopted at all levels in attempts to mitigate impacts and thus provides scope for the translation of the principle into operational measures. As natural entities, cetaceans have their objective intrinsic value, not humanly conferred.