The incidence of ESBL-producing bacteria is increasing worldwide, which represents a challenge for the healthcare systems. More recently, the emergence of the CTX-M group has been frequently reported as being associated with both nosocomial and community acquired infections. CTX-M-15 was identified as being the most prevalent in a large geographic area including Europe and the Middle East, suggesting the presence of a community reservoir of CTX-M enzymes disseminating in the Mediterranean area. Thus, this review will focus on the Mediterranean region to highlight the increasing prevalence of CTX-M-ESBL producing Enterobacteriacae.