The synoptic and mesoscale conditions associated with waterspout occurrence in the Adriatic, Ionian and Aegean Sea are examined in an attempt to quantitatively assess the meteorological environment favourable to the development of waterspouts. For this study, synoptic circulation patterns have been examined for 28 waterspout events in the central-eastern Mediterranean. The waterspouts were reported within the summer and fall of 2002, from July to November, a period of unusually high whirlwind activity. The Adriatic was most active during July, August and September and the Ionian and Aegean during September, October and November. Of the examined waterspout cases, 13 out of the total of 28 were found to be fair-weather waterspouts, while 15 represent tornadic events. For waterspout days, the frequency and distribution of four basic synoptic types, namely, south-west flow (SW), long-wave trough (LW), closed low (CLOSED) and short-wave trough (SWT), were investigated. The particular synoptic features that contributed to the development of waterspout activity were examined, based on five selected waterspout case studies. The mesoscale environment was explored using thermodynamic indices, moisture and wind parameters as derived by operational soundings from the nearest sites (preferably upwind) and closest in time to the waterspout occurrences. The results present an analysis of waterspout types in conjunction to thermodynamic and wind parameters for the purpose of determining synoptic patterns and mesoscale conditions most relevant to waterspout occurrences in these sea areas of the Mediterranean.