The building codes produced by regulatory agencies and adopted as law by a state government define how earthquake shaking and other effects must be considered in the design of new buildings and structures. Specific seismic code regulations for design and constructions are, as usual, different in each country according to seismic activity, the education and experience of professionals, level of building technology, and socio-economic conditions. The east Mediterranean and the Red Sea regions have experienced numerous large earthquakes in the past and they are characterized by relatively high seismic activity at present. Large earthquakes have occurred and are expected along the Dead Sea Transform fault and the Red Sea rift zones. In this chapter, we present a review of seismic design regulation for Egypt, Kingdom Saudi Arabia, Jordan and Lebanon, together with a short description of tectonics and seismicity of the countries and their surroundings.