Tunisia's Ichkeul Lake is among the most productive ecosystems in the Mediterranean, with a great regional value thanks to its diversity of habitats. It is an important overwintering area for waterfowl species. It is a RAMSAR wetland, a National Park, a UNESCO World Heritage, and a Biosphere Reserve. This review paper provides a broad overview of the climatic, hydraulic, biogeochemical features, bio-resources, and bio-productivity of the Lake. The interconnectivity between the different environmental components of the lake is presented, highlighting the main characteristics of this vital ecosystem. Its ecosystem consists of a permanent lake bordered by temporary marshes. It is connected to the Mediterranean Sea via Bizerte Lagoon under a typical semi-arid to sub-humid bio-climate with wet and dry seasons. The winter rainfall fills up the rivers and lake with freshwater that overflows into the Tinja River. In summer, high evaporation reduces the water level and allows seawater to enter the wetland from Bizerte Lagoon. The ecosystem is threatened by pollution, the damming of its main rivers, and climate change. The unsustainable water management has resulted in fundamental environmental modifications, as evidenced by the large variation in the salinity, water level, productivity of water plants, and the decline in venue and stop-overs of waterbirds. The current situation is a warning that indicates a general perturbation of the resources of this particular site and of Tunisian wetlands in general, especially that the Mediterranean region has been designated as a climate change hotspot. Accurate hydrological management is needed to boost the physical functioning of the ecosystem, and to gain deeper knowledge of the different phases of the water cycle and its relationship to other long-term environmental cycles for sustainable water management strategies in the most water-scarce region in the world.