In Europe, the most susceptible areas to land degradation and desertification (LDD) are found in the Mediterranean region. The present study focuses on the island of Lesvos (Greece) and maps the environmental sensitivity of the island to LDD between the years 1990 and 2000. Sensitivity is estimated with a modification of the MEDALUS Environmentally Sensitive Area Index (ESAI) approach, employing 21 quantitative parameters divided in five main quality indices: climate, vegetation, soils, groundwater and socio-economic quality. Parameterisation of these indices is achieved via remote sensing and ancillary data in a Geographical Information System (GIS). Results show that ~85% of the island is fragile or critically sensitive in both epochs. Fragile areas are on the increase, covering an estimated 72% of the island in 1990 and 77% in 2000, whereas critically sensitive areas decrease from 214 to 113 km2. By modifying the ESAI to include 10 additional parameters related to soil erosion, groundwater quality, demographic and grazing pressure, and by applying the modified ESAI in two—rather than one—periods, this study was able to identify that, contrary to previous belief, critically sensitive areas are also found in the eastern side of the island mainly due to human-related factors. It is concluded that the proposed methodology is a useful tool for regional scale trend analyses of environmental sensitivity and the identification of LDD hot spots in Mediterranean environments. Copyright © 2014 John Wiley & Sons, Ltd.