The high species richness, coupled with high proportion of endemism, makes the Mediterranean one of the world’s ‘biodiversity hotspots’. However, the continuous increase in fisheries in the last few decades has led to the overexploitation of their main commercial stocks. Using fishery-independent data collected under the framework of the MEDITS trawl surveys carried out over the last 20 years, we study the demersal fish diversity pattern in the Mediterranean at a large spatial and temporal scale to determine whether it is being affected by the general fishing overexploitation of the demersal resources. The detected diversity trends are compared with the spatio-temporal variation in bottom trawl fishing effort in the Mediterranean. Our results show a stability and even recovery of demersal fish diversity in the Mediterranean together with higher diversity values on the continental shelves of the Balearic Islands, Sardinia, Sicily and the Aegean Sea. At large temporal and spatial scales, the high diversity of demersal assemblages in the Mediterranean is associated with a reduction in bottom trawl fishing effort. The inclusion of species other than target ones through diversity indices is important in the implementation of an ecosystem-based fisheries management.