The Southern Adriatic is recognized as one of the most seismically active regions of the Central Mediterranean. It hosted the strongest historically known and instrumentally recorded earthquakes in Croatia and Montenegro. We conducted a detailed study of algal rims and tidal notches along the Dubrovnik–Konavle coastal area, aimed to contribute in reconstruction of relative sea level (RSL) change, palaeoearthquakes and neotectonics during the last 4500 years. The RSL reconstruction based on high-resolution geochronology showed that the spatial variability of RSL change is largely controlled by local tectonics, leading generally to an alternation of periods of RSL rise and rapid falls caused by coseismic uplift events. During the interseismic periods RSL rose at rates from 1.03 to 0.7 mm/yr before AD, followed by a slowdown to ~0.43 mm/yr, and reaching ~1.3 mm/yr after 1850s. The only exception relates to a period of slow RSL drop probably related to the 3.2 ka cold event. Rapid RSL falls caused by coseismic uplift indicate the occurrence of several large-scale events during the 4th–6th centuries AD, the 800–1360 cal AD period, and in 1395, with hints of earlier events between 1395 cal BC and 565 cal AD. These instances correspond to either unknown or insufficiently documented earthquakes. Conversely, the earthquakes in 1520 and 1667 have been clearly identified. The most compelling evidence of coseismic uplift is associated with the 1667 Dubrovnik earthquake, with an estimated uplift of 40–60 ± 15 cm documented along 40 km of coastline. Analyses of multiple sites with the same high-resolution marker show that Holocene tectonic deformations vary along different fault segments with minimum uplift rates ranging from ~0.3 to ~0.9 mm/yr over ~1.5 ka. The main seismogenic source responsible for coseismic uplifts is attributed to the Dalmatian unit basal thrust and its NE-dipping splays at the Adria-Dinarides boundary. •We provide the relative sea-level reconstruction based on 66 new sea-level index points.•We show significant variability of relative sea-level change due to local tectonic contributions.•New evidence of spatial effects of 1667 AD Dubrovnik earthquake is presented.•The Dalmatian unit basal thrust is a composite seismogenic source responsible for coastal uplifts.•Our data show relative sea-level drop related to 3.2 ka cold event well marked in the Mediterranean.