The coasts of the Mediterranean basin are exposed to the ongoing effects of climate change and anthropogenic pressure. Low elevated coastal plains, river deltas, lagoons and reclamation areas are experiencing beach retreat, coastal erosion and marine flooding. This makes them particularly vulnerable to sea level rise (SLR), which is expected to increase up to 1 m by 2100 AD, according to the projections of the Intergovernmental Panel on Climate Change. In this study, selected stakeholders from four Mediterranean coastal areas that are highly vulnerable to the impacts of SLR have been engaged through a structured participatory process for the development of solution-oriented, case-specific and site-specific Policy Tools to address SLR. The developed Policy Tools for the Venice Lagoon, the Metaponto reclamation area and the Basento river mouth, in Italy, the Ebro River Delta in Spain, and the coastal plain of Chalastra, near the Axios River Delta, in Greece, contain relevant, effective and implementable actions stemming from stakeholder interaction and consensus building. The interconnected stakeholder engagement steps employed in this study identified relevant issues that should be considered when defining SLR adaptation policies to bridge knowledge and perception gaps, facilitate knowledge exchange and foster social learning through structured science communication on SLR. This participatory stakeholder process can lay the foundations for more extensive participation in public processes through which the resulting Policy Tools can materialise into collectively accepted, concrete actions to help vulnerable areas adapt to the expected SLR and consequent coastal hazards by the end of this century.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10669-023-09910-5.