The Mediterranean region serves as an ideal observatory for evaluating the relationships between various factors that define the concept of cultural landscape. This area, characterized by the continuous evolution of social and cultural processes, inherently shapes the identity of its territories (Panaccia (ed.), Mediterranea. Visioni di un mare antico e complesso. Ministero degli Affari Esteri e della Cooperazione Internazionale, 2023). The cultural landscape—comprising people, objects, interactions, and values—should be interpreted as a “living” and “active” element (Niglio, Sul significato di “Paesaggio Culturale” in Italia. Dialoghi Mediterranei, 2023). In this context, participatory design methods can significantly contribute to defining and envisioning future pathways (Del Soldato and Massari, EuroMed J Bus 19(1):113–137, 2024). This paper aims to present the role of designers in synthesizing the past and present to prioritize and articulate complex phenomena, ultimately shaping co-constructed knowledge and skills for the future. Various case studies of design applications in Mediterranean contexts will be presented, illustrating how designers have transitioned from being mere producers of objects to facilitators of transformation processes, thanks to the acquisition of a systemic vision and the development of specific design methodologies that apply it. This evolution redefines the very concept of cultural good and establishes the designer’s role in “Cultural Heritage.” This concept implies an active idea of conservation through use, enabling heritage to be enhanced and new cultural assets to be co-produced (Irace, Ciagà, Lupo, Trocchianesi (eds), Design and cultural heritage. Mondadori Electa, Milan, 2014). The paper will conclude with an overview of a doctoral research project initiated by one of the authors this year. This project employs a systemic design approach to actively engage residents of specific locations on several minor Mediterranean islands. Through participatory and collaborative workshops, symbols and metaphors are identified to serve as “activators” of stories (Brown, Gray, Macanufo, Gamestorming: a playbook for innovators, rulebreakers, and changemakers. O’Reilly Media, Sebastopol, 2010). These communities are chosen for their unique position to actively testify and participate, expressing awareness of the relationship between their local knowledge and the broader intercultural and supranational dimensions of the Mediterranean context. In conclusion, this paper aims to demonstrate how design is now a fundamental trans-disciplinary and practical field for the conception and articulation of complex projects dedicated to the enhancement of Mediterranean cultural heritage.