This study provides a detailed reconstruction of cold-water coral mound build-up within the East Melilla Coral Province (southeastern Alboran Sea), more precisely at the northern part of Brittlestar Ridge I, over the last 300 kyr. The multiproxy investigation of core MD13-3462G reveals that mound build-up took place during both interglacial and glacial periods at average aggradation rates ranging between 1 and 10 cm kyr−1. These observations imply that corals never thrived but rather developed under stressful environmental conditions. Maximum aggradation rates of 18 cm kyr−1 are recorded during the last glacial period, hence providing the first evidence of coral mound development during this time period in the western Mediterranean. The planktonic (Globigerina bulloides) and benthic (Lobatula lobatula) δ18O records from core MD13-3462G show typical interglacial–glacial variations during the last two interglacial–glacial cycles. This is in contrast with δ18O records generally recovered from coral mounds and highlights that the northern part of Brittlestar Ridge I experienced reduced albeit relatively continuous accretion. High abundances of infaunal benthic foraminifera (Bulimina marginata, Bulimina striata, and Uvigerina mediterranea) suggest that weak seafloor oxygenation associated with important terrestrial organic matter input characterized interglacial periods, whilst the dominance of large epibenthic species (Discanomalina coronata and Lobatula lobatula) and Miliolids is probably linked to stronger Levantine Intermediate Water circulation and fresher organic matter input during glacial periods. In addition, the computed tomography (CT) quantification of macrofaunal remains shows that the bryozoan Buskea dichotoma is present throughout the entire 300 kyr of mound build-up history, with the exception of MIS 5, and is possibly a key contributor to mound development during glacial periods. The comparison of our observations to other long-term coral mound records demonstrates that western and central Mediterranean coral mounds do not show concurrent build-up over interglacial–glacial cycles, implying that their development may be driven by regional and local environmental forcing.