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The wedge clam Donax trunculus is commonly used in environmental monitoring studies as sentinel species for the biomonitoring of sandy beaches in Mediterranean areas. Taking in account the combined effects of chemical stressors and global changes in marine organisms, research efforts in ecotoxicology should be up-to-date for a more relevant and integrative monitoring studies. In the same context, it is an actual need to select bioindicators able to reflect both global change effects and conventional/emergent stressors in marine ecosystems. D. trunculus indeed appears as appropriate integrative sentinel specie. Apart from being an easy to collect species, D. trunculus presents many advantages justifying its use in (eco)toxicological studies such as large distribution, bioaccumulation capacity, responses (biomarkers) to contaminants and well studied biology, physiology and ecology. Herein, we propose a review based on a literature survey of (eco)toxicological aspects of D. trunculus with a special focus on the suitability of its use as a sentinel species in laboratory/ field studies and as potential indicator for regional and global changes. We recommend its further use in the environmental impact assessment of emerging contaminants (such as pharmaceuticals, micro and nanoplastics). Recommendations for an integrative environmental monitoring in a global change context are also highlighted.