The main mycotoxigenic fungi found in maize in the Mediterranean basin include Aspergillus section Flavi and several Fusarium species, Fusarium section Liseola being the more widespread. While Aspergillus section Flavi species can develop in the field or in stored maize in Mediterranean countries, Fusarium species colonise maize ears in the field. As a consequence, fumonisins are the major contaminants in Mediterranean maize, together with aflatoxins. The prevalence of Fusarium section Liseola in the Mediterranean countries is closely linked to the activity of insects such as Sesamia nonagrioides and Ostrinia nubilalis. The incidence of the different mycotoxigenic fungi and mycotoxins across the Mediterranean countries is extensively reviewed in this work. Furthermore, both pre- and postharvest strategies to reduce the presence of such toxins in the maize chain are described. Finally, the incidence and levels of mycotoxins encountered in maize products intended for direct human consumption in the Mediterranean countries are also assessed; they are much lower than those in maize grain as a result of food processing technologies.