This chapter investigates the conditions under which benefits of transhipment ports may flow to the region or country hosting them. It illustrates the start-up, consolidation and performance of the port, and discusses the reasons explaining such performance. A special form of port activity is transhipment, a scheme of transport consisting of disembarking cargo from a large ship in an intermediate destination port and then embarking it onto smaller ships for onward transport to its final destination. In fact, while the total transhipment activity in a market region is overall stable over time, individual transhipment hubs could experience significant fluctuation in their market share as a consequence of commercial strategies of private operators. The transhipment market is dominated by a few major companies who change their strategies quite quickly to react to context and market developments. The transhipment and related activities created additional direct and indirect employment for Medcenter Container Terminal (MCT) and the shipping companies providing direct services to MCT.