The study of water quality and the quantification of reserves and their variations according to natural and anthropogenic forcing is necessary to establish an adequate management plan for groundwater resources. For this purpose, a modeling approach is a useful tool that allows, after calibration phase and verification of simulation, and under different scenarios of forcing and operational changes, to estimate and control the groundwater quantity and quality. The main objective of this study is to collect all available data in a model that simulates the Jeffara of Medenine coastal aquifer system functioning. To achieve this goal, a conceptual model was constructed based on previous studies and hydrogeological investigations. The regional groundwater numerical flow model for the Jeffara aquifer was developed using MODFLOW working under steady-state and transient conditions. Groundwater elevations measured from the piezometric wells distributed throughout the study area in 1973 were selected as the target water levels for steady state (head) model calibration. A transient simulation was undertaken for the 42 years from 1973 to 2015. The historical transient model calibration was satisfactory, consistent with the continuous piezometric decline in response to the increase in groundwater abstraction. The developed numerical model was used to study the system's behavior over the next 35 years under various constraints. Two scenarios for potential groundwater extraction for the period 2015-2050 are presented. The predictive simulations show the effect of the increase of the exploitation on the piezometric levels. To study the phenomenon of salinization, which is one of the most severe and widespread groundwater contamination problems, especially in coastal regions, a solute transport model has been constructed by using MT3DMS software coupled with the groundwater flow model. The best calibration results are obtained when the connection with the overlying superficial aquifer is considered suggesting that groundwater contamination originates from this aquifer. Recommendations for water resource managers The results of this study show that Groundwater resources of Jeffara of Medenine coastal aquifer in Tunisia are under immense pressure from multiple stresses. The water resources manager must consider the impact of economic and demographic development in groundwater management to avoid the intrusion of saline water. The results obtained presented some reference information that can serve as a basis for water resources planning. The model runs to provide information that managers can use to regulate and adequately control the Jeffara of Medenine water resources.