Background: The objective of this study was to analyze the current situation of the truffle sector in the main producing countries of the Mediterranean area. Additionally, we identified the challenges for the future and the priority actions to develop the truffle sector in the region. Methods: We used a Delphi process approach, and we selected a total of 17 expert panelists in different positions within the supply chain of the target countries (Spain, France, Italy, Croatia, and Greece). Results: The results obtained allowed us to have a complete description of the current truffle supply chain. We confirmed an evolution of the sector due to the cultivation success of several Tuber species. The maturity of the sector has produced shifts in the roles that form the traditional truffle supply chain operators. We confirmed the trend of a decrease of collectors that hunt truffles in the wild and sell to small travelling buyers, whilst truffle hunters that collect for farmers and specialty wholesalers are emerging. However, a trend of truffle price decrease in the last few years has alerted the sector. Conclusions: As production increases due to truffle cultivation, it will be necessary to promote truffle consumption. We identified actions to develop the truffle sector: (a) strengthen the link between truffles, tourism, and gastronomy; (b) increase the effort at European level for the recognition of truffle production, helping to develop truffle culture and marketing; (c) increase the awareness and consumption of truffles among consumers; and (d) develop tourism workshops for truffle farmers.