This paper reviews recent demographic and familial changes in the Middle East and North African countries (MENA), which parallel the developments associated with the second demographic transition that has transformed population profiles and family life in the more developed OECD countries. The emerging needs for family-oriented policies are analysed in relation to these changes. And the current levels of social protection in the MENA region are assessed along with the recent measures initiated in response to the COVID-19 pandemic. The paper offers evidence of the demographic transition underway in the region, as many countries are experiencing declining fertility rates combined with an increase in life expectancy, which creates a rising old age dependency ratio. This in turn adds an additional burden of elderly dependents on the working age population and on the state’s capacity to care for elderly dependents, which generates an increasing need to expand social protection in the MENA region.