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This study demonstrates the application of Electrical Resistivity Tomography (ERT) to investigate subsurface lithologies and sedimentary structures across coastal transition zones in southern Italy. By integrating onshore and nearshore (shallow-water) ERT surveys, we reconstructed a detailed hydrogeological and lithological model essential for engineering and environmental assessments, such as submarine cable installations and coastal infrastructure planning. The methodology involved simultaneous data acquisition on land and at sea, with inversion processing that accounted for sea-land topography and variations in water resistivity. Case studies from the Pontecagnano coastal area revealed distinct resistivity zones corresponding to marine sediments, mixed deposits, and freshwater-bearing terrestrial sediments. Notably, the survey clearly mapped seawater intrusion into coastal aquifers—a critical factor for groundwater management. Our findings demonstrate that ERT is a cost-effective, non-invasive tool for characterizing coastal subsurfaces, monitoring saltwater intrusion, and informing sustainable coastal zone management strategies.