We review the measurement of the mean dynamic topography (MDT) of the Mediterranean using ellipsoidal heights of sea level at discrete tide gauge locations, and across the entire basin using satellite altimetry, subtracting estimates of the geoid obtained from recent models. This ‘geodetic approach’ to the determination of the MDT can be compared to the independent ‘ocean approach’ that involves the use of in situ oceanographic measurements and ocean modelling. We demonstrate that with modern geoid and ocean models there is an encouraging level of consistency between the two sets of MDTs. In addition, we show how important geodetic MDT information can be in judging between existing global ocean circulation models, and in providing insight for the development of new ones. The review makes clear the major limitations in Mediterranean data sets that prevent a more complete validation, including the need for improved geoid models of high spatial resolution and accuracy. Suggestions are made on how a greater amount of reliable geo-located tide gauge information can be obtained in the future.