The goal of this work is to evaluate by a modeling approach the effectiveness of alternative fuel treatment strategies to reduce potential losses from wildfires in Mediterranean areas. We compared strategic fuel treatments located near specific human values vs random locations, and treated 3, 9 and 15% of a 68,000 ha study area located in Sardinia, Italy. The effectiveness of each fuel treatment was assessed by simulating 25,000 wildfires using the MTT fire spread algorithm. The simulations replicated severe wildfires observed around the study area, using historic weather and fuel moisture conditions (97th percentile). Wildfire exposure profiles for the study area as a whole and for locations with specific values of interest were analyzed. Results indicated significant variations in wildfire exposure among and within the fuel management strategies and treatment intensities. The simulated mitigation strategies substantially decreased the average wildfire exposure with respect to the untreated condition, and this effect was unequivocal for all strategies. Increasing the percentage of land treated improved the effectiveness of all fuel treatment strategies. The strategy based on road protection provided the highest performances for several wildfire exposure indicators. The methodology presented in this work can be applied to facilitate the design of fuel management programs and support policy decisions to address growing wildfire risk in the region. This work is one of the first applications of fire simulation modeling to evaluate fuel management effectiveness on wildfire risk mitigation in the Mediterranean areas.