Mount Etna is the largest active volcano in Europe. Instability of its eastern flank is well documented onshore, and continuously monitored by geodetic and InSAR measurements. Little is known, however, about the offshore extension of the eastern volcano flank, defining a serious shortcoming in stability models. In order to better constrain the active tectonics of the continental margin offshore the eastern flank of the volcano, we acquired a new high-resolution 2D reflection seismic dataset. The data provide new insights into the heterogeneous geology and tectonics at the continental margin offshore Mt Etna. The submarine realm is characterized by different blocks, which are controlled by local- and regional tectonics. A compressional regime is found at the toe of the continental margin, which is bound to a complex basin system. Both, the clear link between on- and offshore tectonic structures as well as the compressional regime at the easternmost flank edge, indicate a continental margin gravitational collapse as well as spreading to be present at Mt Etna. Moreover, we find evidence for the offshore southern boundary of the moving flank, which is identified as a right lateral oblique fault north of Catania Canyon. Our findings suggest a coupled volcano edifice/continental margin instability at Mt Etna, demonstrating first order linkage between on- and offshore tectonic processes.