The availability of water is still one of the most important factors affecting the sustainable growth of a country. Although many countries have free access to an inexhaustible source of water, the sea, this source cannot be used for human purposes as it is. To face this problem, desalination has been proposed for freshwater production but the generation of a waste brine effluent poses some issues of actual sustainability. In this work, the operation results of a Multiple Effect Distillation (MED) demo plant, designed for stable operation at high brine concentrations and operated as a brine concentrator, are presented. To this purpose, the integration with NanoFiltration (NF) has been implemented to minimize scaling risks, by removing bivalent ions from the feed stream. The 2-effects MED pilot unit, with a capacity of 1.7 m³/h, has been installed as part of the treatment chain of the WATER-MINING project, within the premises of the power station of the island of Lampedusa (Sicily, Italy) and is fully powered by waste heat at 70–80 °C from diesel engines. A vapor temperature of 40–50 °C allowed a perfect coupling with the low temperature waste heat source, demonstrating the possibility to produce distilled water with a conductivity between 15 and 25 μs/cm. Among the several operating conditions investigated, a recovery ratio above 80 % has been achieved and an effluent brine conductivity of 240 mS/cm was produced, very close to saturation in NaCl, thus being excellent for food-grade sea salt production in evaporative ponds. For the first time, it has been demonstrated on a pilot scale how a MED unit, supplied with waste heat, can be used efficiently as a brine concentrator, obtaining a brine concentration 8 times higher than the input concentration without any scaling problem.