We present a novel three-dimensional anisotropic seismic tomography of the Mediterranean region, achieved through the simultaneous inversion of P-wave travel times and SKS splitting intensity. This dual approach has allowed us to obtain a comprehensive tomographic model that not only delineates the primary structural features of the area but also sheds light on its tectonic evolution. Our findings reveal that the isotropic component of the model is dominated by fast anomalies linked to retreating, stagnant, and detached slab segments, while slower mantle structures are associated with slab windows and back-arc basin formation. The recovered anisotropic patterns provide crucial insights into the tectonic history of the Mediterranean, highlighting periods of collision and tectonic relaxation. Notably, we observe a range of plunge angles, with both near-horizontal and steeply dipping fabrics present in different regions, reflecting the influence of horizontal and vertical asthenospheric flows. By interpreting the high-velocity zones as subducting lithosphere, we constructed a detailed 3-D model of the main slabs and analyzed the surrounding P-wave anisotropic patterns. This work represents the first comprehensive anisotropic tomography of the entire Mediterranean, underscoring the significance of seismic anisotropy in constraining the upper mantle structure and elucidating the region's tectonic dynamics throughout its geological history.