This document sets forth a proposal to designate the Mediterranean Sea, as a whole, as an Emission Control Area for Sulphur Oxides, hereinafter referred to as the proposed ʺMed SOX ECAʺ, in accordance with regulation 14 and Appendix III to MARPOL Annex VI to take effect from 1 January 2025. The document shows that the designation of the proposed Med SOX ECA is supported by a demonstrated need to prevent, reduce and control emissions of sulphur oxides and particulate matter from ships. Moreover, the adoption of the proposed Med SOX ECA will result in significant reductions in ambient levels of air pollution in the Mediterranean Sea, as a whole, and in the Mediterranean coastal States, which will achieve substantial benefits to human health and the environment. The co-sponsors invite the Committee to review this proposal at this session with a view towards the adoption by the Parties to MARPOL Annex VI, at MEPC 79, of amendments to regulation 14.3 and Appendix VII to MARPOL Annex VI designating the Med SOX ECA as a new Emission Control Area.