The seagrass Posidonia oceanica is the main habitat-forming species of the coastal Mediterranean, providing millennial-scale ecosystem services including habitat provisioning, biodiversity maintenance, food security, coastal protection, and carbon sequestration. Meadows of this endemic seagrass species represent the largest carbon storage among seagrasses around the world, largely contributing to global blue carbon stocks. Yet, the slow growth of this temperate species and the extreme projected temperature and sea-level rise due to climate change increase the risk of reduction and loss of these services. Currently, there are knowledge gaps in its basin-wide spatially explicit extent and relevant accounting, therefore accurate and efficient mapping of its distribution and trajectories of change is needed. Here, we leveraged contemporary advances in Earth Observation—cloud computing, open satellite data, and machine learning—with field observations through a cloud-native geoprocessing framework to account the spatially explicit ecosystem extent of P. oceanica seagrass across its full bioregional scale. Employing 279,186 Sentinel-2 satellite images between 2015 and 2019, and a human-labeled training dataset of 62,928 pixels, we mapped 19,020 km2 of P. oceanica meadows up to 25 m of depth in 22 Mediterranean countries, across a total seabed area of 56,783 km2. Using 2,480 independent, field-based points, we observe an overall accuracy of 72%. We include and discuss global and region-specific seagrass blue carbon stocks using our bioregional seagrass extent estimate. As reference data collections, remote sensing technology and biophysical modelling improve and coalesce, such spatial ecosystem extent accounts could further support physical and monetary accounting of seagrass condition and ecosystem services, like blue carbon and coastal biodiversity. We envisage that effective policy uptake of these holistic seagrass accounts in national climate strategies and financing could accelerate transparent natural climate solutions and coastal resilience, far beyond the physical location of seagrass beds.