In Mediterranean European countries, 85% of the assessed stocks are currently overfished compared to a maximum sustainable yield reference value (MSY) while populations of many commercial species are characterized by truncated size- and age-structures. Rebuilding the size- and age-structure of exploited populations is a management objective that combines single species targets such as MSY with specific goals of the ecosystem approach to fisheries management (EAF), preserving community size-structure and the ecological role of different species. Here, we show that under the current fishing regime, stock productivity and fleet profitability are generally impaired by a combination of high fishing mortality and inadequate selectivity patterns. For most of the stocks analysed, a simple reduction in the current fishing mortality (Fcur) towards an MSY reference value (FMSY), without any change in the fishing selectivity, will allow neither stock biomass nor fisheries yield and revenue to be maximized. On the contrary, management targets can be achieved only through a radical change in fisheries selectivity. Shifting the size of first capture towards the size at which fish cohorts achieve their maximum biomass, the so-called optimal length, would produce on average between two and three times higher economic yields and much higher biomass at sea for the exploited stocks. Moreover, it would contribute to restore marine ecosystem structure and resilience to enhance ecosystem services such as reservoirs of biodiversity and functioning food webs.