This study analyzes the progress in information and communication technologies (ICT) in eleven MED countries and how they compare to the rest of the world in terms of sector's sophistication and development. In recent years, most countries of this region opened up their markets for multiple players, greatly enhancing competition and increasing the number and quality of services. However, compared with the rest of the world, the region has still lagged behind. Yet this could change fairly rapidly as more countries adopt liberalization polices and good governance that would attract FDI and expand the markets. Being a laggard may actually avail some benefits, as countries adopt best practices and learn from the pitfalls of earlier liberalizers! Compared to other regions, generally MED countries rank below the Americas and Europe in terms of cellular, fixed and Internet adoption rates. However, they rank above Africa across all services and above Asia/Pacific in cellular and Internet services penetration. Looking ahead, the paper analyzes three scenarios for the coming 20 years; pessimistic, steady state and optimistic. There are a number of key factors that would drive these various scenarios and their illustrative outcomes, such as the investment climate, regulatory institutions (this includes the rule of law, judiciary, transparency and fairness) and the government openness to participation of citizens in public affairs.