The high plant diversity of mediterranean-climate regions has attracted much attention over the past few years. This review discusses patterns and determinants of local, differential and regional plant diversity in all five regions. Local diversity shows great variation within and between regions and explanations for these patterns invoke a wide range of hypotheses. Patterns of regional diversity are the result of differential speciation and extinction rates during the Quaternary. These rates have been influenced more by the incidence of fire and the severity of climate change than by environmental heterogeneity. All regions have a high number of rare and locally endemic taxa that survive as small populations, many of which are threatened by habitat transformation.