We review the Palaeozoic-Early Mesozoic evolution of the Eastern Mediterranean-Balkan region with special reference to Anatolia, and provide new isotopic data on the Palaeozoic magmatic and metamorphic rocks. The pre-Alpide evolution of the region involves episodic growth of Laurussia by accretion of oceanic terranes and Gondwana-derived microcontinents. Terrane accretion, associated with deformation, magmatism and regional metamorphism, took place in the Late Ordovician-Early Silurian, Carboniferous, Late Triassic-Early Jurassic and Mid-Jurassic. The Late Ordovician-Early Silurian accretion is inferred from stratigraphic and faunal records in the Pontides; other evidence for it is buried under young cover on the northern margin of the Black Sea. The Carboniferous orogeny is related to southward subduction and continental collision on the southern margin of Laurussia. It is marked in the Pontides by high-grade regional metamorphism, north-vergent deformation and post-orogenic latest Carboniferous-Early Permian plutonism. The latest Triassic-Early Jurassic Cimmeride orogeny involved the collision and amalgamation of an oceanic plateau to the southern margin of Laurasia. It is represented by voluminous accretionary complexes with Late Triassic blues-chists and eclogites. Late Jurassic regional metamorphism and deformation is confined to the Balkans, and is the result of continental collision between the Rhodope-Serbo-Macedonian and Strandja blocks in the Late Jurassic. The Palaeozoic geological history of the Balkans and the Pontides resembles that of Central Europe, although the similarities end with the Mesozoic, as a consequence of the formation of Pangaea.