During the past few decades, coastal wetlands in the Mediterranean region experienced phases of generalized and intense destruction followed by increasingly effective and widespread conservation policies. The case of Sardinia, analyzed through the complex relations among fishing activities and environmental protection within changing institutional frameworks in Tortolì and Cabras, shows interesting examples of growing awareness of the value of ecosystemic services. The overlapping of projects related to recreation and tourism and the revitalization of fishing traditions and productions, along with widespread critical issues still related to the expansion of human activities in fragile coastal environments and to a persistently marginal socio-economic context, creates crucial challenges for local development. The analysis of these systems shows their changing character, through complex forms of relations among wetland environments and human societies, and highlights the potential and risks of locally managed planning.