The constant threat posed by piracy in the region during the previous ages did not allow the islet settlements to grow larger and only Cunda Island (alternatively known as Alibey Island, known among the Greeks as Moschonisia, literally “The Perfumed Island”) could maintain a higher level of habitation as it is the largest and the closest islet to the mainland.

After the Byzantine period, the region came under the rule of the Anatolian beylik of Karasi in the 13th century and was later annexed to the territory of the Ottoman beylik (principality), which was to become the Ottoman Empire in the following centuries. The locals contributed with their economies to the Greek struggle for independence, including the famous Psorokostaina.