This systematic review examines the relationship between adherence to the Mediterranean diet and sleep features, including sleep quality, duration, daytime sleepiness, and insomnia symptoms. The study included 23 observational reports from various countries, with a majority conducted in the Mediterranean basin. The findings suggest that higher adherence to the Mediterranean diet is associated with better sleep quality, adequate sleep duration, reduced daytime sleepiness, and fewer insomnia symptoms. These associations were observed in both cross-sectional and longitudinal studies, indicating a potential bidirectional relationship. The Mediterranean diet's emphasis on plant-based foods, healthy fats, moderate animal product intake, and regular consumption of olive oil and wine may contribute to these benefits through their antioxidant and anti-inflammatory properties. The review highlights the importance of further research to understand the mechanisms underlying this relationship and to explore the potential of promoting the Mediterranean diet as a tool to improve sleep quality.This systematic review examines the relationship between adherence to the Mediterranean diet and sleep features, including sleep quality, duration, daytime sleepiness, and insomnia symptoms. The study included 23 observational reports from various countries, with a majority conducted in the Mediterranean basin. The findings suggest that higher adherence to the Mediterranean diet is associated with better sleep quality, adequate sleep duration, reduced daytime sleepiness, and fewer insomnia symptoms. These associations were observed in both cross-sectional and longitudinal studies, indicating a potential bidirectional relationship. The Mediterranean diet's emphasis on plant-based foods, healthy fats, moderate animal product intake, and regular consumption of olive oil and wine may contribute to these benefits through their antioxidant and anti-inflammatory properties. The review highlights the importance of further research to understand the mechanisms underlying this relationship and to explore the potential of promoting the Mediterranean diet as a tool to improve sleep quality.