Marine ecosystems are facing unprecedented pressures for instance rising water temperatures, changing current patterns and ocean acidification. Coastal systems in particular are also challenged with additional anthropogenic pressures caused by accelerating rates of human settlement near the coast. This trend places increasing strains on the delivery of ecosystem services associated with recreation but also coastal fisheries. Here we introduce the concepts related to ecosystem stability and ecosystem services and review the evidence for regime shifts in the world's ecosystems with particular reference to the Mediterranean, before reviewing mechanisms for ecosystem valuations, ending with recommendations for increasing the practical relevance of future ecosystem evaluations. We stress the need for regional approaches, taking into account the views and needs of local populations, which might differ greatly geographically even for the same issue being considered.