It was created in October 1990 in Rome under the name of 5+5 Dialogue or the Western Mediterranean Forum, as the first forum for improved cooperation between the two shores of the Mediterranean. It represented the launch of the Renewed Mediterranean Policy in the search for common solutions to shared problems, strengthening the Arab Maghreb Union (AMU) created in 1989 and building bridges with what was then the European Communities.

The group is informal in nature and works towards greater integration in the Mediterranean basin. It originally began in a Foreign Affairs format (Rome, 1990 and Algiers, 1991). Subsequently, it was extended to other formats: Home Affairs (1995), Transport (1995), Migration (2002), Defence (2004), Tourism (2006), Education (2009), the Environment and Renewable Energies (2010), Agriculture and Food Security (2013), Water (2015), the Economy (2013), Innovation and Higher Education (2013), Water (2015), Finance (2017) and Culture (2017). The work at these ministerial conferences is managed by the ministerial departments in each area.

Between 1992 and 2001, the 5+5 Group froze its meetings of foreign affairs ministers as a result of the UN sanctions on Libya due to a lack of collaboration with attempts to investigate the Lockerbie attack. However, ministerial meetings were held in the area of Home Affairs (1995) and Transport (1995).

In January 2001, the Foreign Affairs ministers of the 5+5 Group met again in Lisbon. The level of talks reached its highest point with a 5+5 summit of heads of state and government held in Tunisia in December 2003. Following the Foreign Affairs meeting in Oran on 24 November 2004, there have been further meetings in Valletta (June 2005), Rabat (January 2008), Cordoba (April 2009), Tunis (April 2010), Rome (February 2012), Nouakchott (April 2013), Lisbon (May 2014), Tangier (October 2015) and Marseilles (October 2016). In October 2012, the second summit of heads of state and government was held in Malta. Furthermore, the speakers of the parliaments of the member states met for the first time in Tripoli in February 2003, and have now held four meetings (Paris 2004, Rabat 2006 and Nouakchott 2013).

The ministerial meetings have proved to be of great practical use. By way of example, in 2015 the first ministerial meeting on water saw the approval of the Water Strategy for the Western Mediterranean, at the initiative of Spain and Algeria.

The Mediterranean Forum
During the crisis of the 5+5 forum resulting from the sanctions against Libya, 11 Mediterranean countries (Algiers, Egypt, France, Greece, Italy, Malta, Morocco, Portugal, Spain, Tunisia and Turkey) created the Mediterranean Forum at a meeting in Alexandria in 1994. This forum also functioned as a think tank for the Barcelona Process. The Forum has convened in Sainte-Maxime (France) in 1995, Ravello in 1996, Algiers in 1997, Palma de Mallorca in 1998, Valletta in 1999, Funchal in 2000, Tangier in 2001, Delos in 2002, Antalya in 2003, Tunis in 2005, Cairo in 2005, Alicante in 2006, Crete in 2007 and Algiers in 2008.

The flexible nature of the Forum and the absence of countries directly involved in the Middle East conflict have allowed participants to strengthen ties before the meetings of the 43 members of the Union for the Mediterranean (UfM). Spain chaired the ad-hoc group on terrorism that agreed a Code of Conduct at the Delos Ministerial Union in June 2002.

With the return of the 5+5 Dialogue, the former forum has been losing strength, although the foreign affairs ministers met in Rome in February 2012.