Flooding affects Mediterranean coastal areas, with negative impacts on regional populations and ecosystems. This paper reviews the causes and consequences of coastal flooding in European Mediterranean countries, common and advanced solutions implemented to mitigate flood risk, and the importance of stakeholder involvement in developing these solutions. Climate change, intensive urbanization, tourism, deforestation, wildfires, and erosion are the main causes of coastal flooding, leading to social and economic losses, degradation of ecosystems, and water and soil contamination due to saltwater intrusion. Various measures for mitigating urban coastal flooding have been implemented, including coastal barriers, infrastructural drainage systems, wetlands, and mobile dams. Development and implementation of such solutions should be performed in close collaboration with stakeholders, but their current engagement at the coordination and/or decision-making level does not allow full integration of local knowledge in flood mitigation projects. Various processes are used to engage stakeholders in coastal flood mitigation, but participatory approaches are required to integrate their perspectives into performance analysis of potential solutions. Such approaches would allow a balance to be reached between nature conservation, market forces, stakeholder needs, and decision-makers’ priorities, resulting in development of innovative and sustainable mitigation solutions to enhance urban resilience to coastal flooding.