Monterosso al Mare is located at the center of a small natural gulf, protected by a small artificial reef, to the east of Punta Mesco in the Riviera of La Spezia. It is the westernmost of the Cinque Terre. In the west part of the original village, beyond the hill of the Capuchins, it is the village of Fegina, natural expansion and characterized by a relatively modern tourist resort facility compared to the ancient village that is reachable through a tunnel of a few tens of meters. The local train station is located at Fegina and the beaches are relatively larger compared to the narrow cliffs that characterize the other villages of the Cinque Terre.
The town is divided into two distinct parts: the old town and the new town. The two areas are divided by a single tunnel that caters to pedestrians and the very few cars in the town.