A detailed tephrostratigraphic record, which dates back to Marine Isotope Stage (MIS) 5b (ca. 91 kyr), has been established from a 17.76 m long core (Co1215) from Lake Prespa (Macedonia, Albania and Greece). A total of eleven tephra and cryptotephra layers (PT0915-1 to PT0915-11) were identified, using XRF scanning, magnetic susceptibility measurements, and macro- and microscopic inspection of the sediments. The major element composition of glass shards and/or micro-pumice fragments indicates that the tephras and cryptotephras originate from the explosive volcanism of Italy. Eight tephra and cryptotephra layers were correlated with specific volcanic eruptions: the AD 512 eruption of Somma-Vesuvius (1438 cal yr BP), the Mercato eruption of Somma-Vesuvius (8890 ± 90 cal yr BP), the Tufi Biancastri/LN1-LN2 eruption of the Campi Flegrei (14 749 ± 523 cal yr BP and 15 551 ± 621 cal yr BP), the SMP1-e/Y-3 eruption of the Campi Flegrei (30 000–31 000 cal yr BP), the Campanian Ignimbrite/Y-5 eruption of the Campi Flegrei (39 280 ± 110 cal yr BP), the SMP1-a event of Ischia Island (around 44 000 cal yr BP) and the Green Tuff/Y-6 eruption of Pantelleria Island (around 45 000 cal yr BP). One tephra could be attributed to the volcanic activity of Mount Etna, but probably represents an unknown eruption at ca. 60 000 cal yr BP. Cryptotephras PT0915-6 and PT0915-10 remain unclassified so far, but according to the presented age-depth model these would have been deposited around 35 000 and 48 500 cal yr BP, respectively. Some of the tephras and cryptotephras are recognised for the first time in the Balkan region. The tephrostratigraphic work provides important information about ash dispersal and explosion patterns of source volcanoes and can be used to correlate and date geographically distant paleoenvironmental and archaeological archives in the central Mediterranean region. Moreover, the tephrostratigraphic work in combination with radiocarbon and electron spin resonance (ESR) dating is a precondition for paleoclimatic reconstructions inferred from the sediment succession Co1215.