Political and economic changes over the last ten years have intensified agri-food trade among Mediterranean countries. This paper aims to examine the exchanges between Italy and these countries. The analysis of these exchanges highlight trends that indicate Italy's agri-food balance has deteriorated during the previous ten years. A Constant Market Shares Analysis has been performed on Italy's fruit and vegetable imports from Egypt, Turkey, Morocco and Tunisia, which aims to assess their competitiveness. The results are then compared with those of Italy's major fruit and vegetable suppliers, the EU and Latin America, which indicate some Mediterranean Partners have high levels of competitiveness.