The occurrence and spread of brown ring disease (BRD) to several northern Mediterranean coasts is described. We report the results of a 6-y surveillance of BRD in natural populations of carpet shell clams (Ruditapes decussatus) in 14 zones along the Gulf of Gabes in Tunisia (southern Mediterranean Sea). BRD symptoms in adult animals resulting from conchiolin deposits in inner parts of carpet shell were observed in all zones surveyed. Infestation rates within each site ranged from 65–100%, and BRD prevalence varied from 1–58% of clams in winter and from 1–33% in summer. Positive correlations were demonstrated between BRD prevalence and Vibrio spp. concentrations in clams. Vibrio tapetis was not identified among the bacterial organisms, suggesting that other marine Vibrio species are capable of causing BRD-like illness in carpet shell clams.