The Mediterranean basin has been the cradle of some of the world’s greatest civilizations based on a cultural landscape formed by a mosaic of agro-silvo-pastoral patches developed in, and around human settlements. Since antiquity, these hot spots of human activities have faced several challenges with the most alerting ones lately, related to climate-change. Nature and nature-based solutions (NbS) are crucial in addressing the climate crisis. In this context, understanding the role of Mediterranean Agrosilvopastoral Ecosystems (MAEs) in mitigating climate extremes is essential. MAEs provide diverse ecosystem services (ESs), yet are increasingly threatened by climate change, monocultures, renewable energy infrastructure, rural exodus, agricultural intensification, decline of water table, wildfires, soil sealing, and urban sprawl. These pressures undermine their resilience and climate-regulating functions. Desertification and wildfires interact synergistically, amplifying risks and accelerating habitat loss. As extreme climate events intensify and become more frequent, maintaining MAEs is crucial for water regulation, storage, and resilience against erratic but heavy rainfall. This study relies on a narrative review delving into their multifunctionality, and multiscalarity that guarantees co-benefits to urban communities. They provide ecological and socio-cultural ESs (e.g., social cohesion, cultural heritage enhancement), but also create economic opportunities (green economy employment, circular economy options, payments for ESs, ecotourism, etc.). The spectrum of co-benefits directly and indirectly linked to the sustainable design and management of MAEs-based solutions can enhance strategically the quality of life for urban residents.