This paper assesses historic changes in mean sea level around the coastline of the North Sea, one of the most densely populated coasts in the world. Typically, such analyses have been conducted at a national level, and detailed geographically wider analyses have not been undertaken for about 20 years. We analyse long records (up to 200 years) from 30 tide gauge sites, which are reasonably uniformly distributed along the coastline, and: (1) calculate relative sea level trends; (2) examine the inter-annual and decadal variations; (3) estimate regional geocentric (sometimes also referred to as ‘absolute’) sea level rise throughout the 20th century; and (4) assess the evidence for regional acceleration of sea-level rise. Relative sea level changes are broadly consistent with known vertical land movement patterns. The inter-annual and decadal variability is partly coherent across the region, but with some differences between the Inner North Sea and the English Channel. Data sets from various sources are used to provide estimates of the geocentric sea level changes. The long-term geocentric mean sea level trend for the 1900 to 2011 period is estimated to be 1.5 ± 0.1 mm/yr for the entire North Sea region. The trend is slightly higher for the Inner North Sea (i.e. 1.6 ± 0.1 mm/yr), and smaller but not significantly different on the 95% confidence level for the English Channel (i.e. 1.2 ± 0.1 mm/yr). The uncertainties in the estimates of vertical land movement rates are still large, and the results from a broad range of approaches for determining these rates are not consistent. Periods of sea level rise acceleration are detected at different times throughout the last 200 years and are to some extent related to air pressure variations. The recent rates of sea level rise (i.e. over the last two to three decades) are high compared to the long-term average, but are comparable to those which have been observed at other times in the late 19th and 20th century.