Transition from subduction to collision occurs in Western Greece and is accommodated along the downgoing plate by the Kefalonia right-lateral fault that transfers the Hellenic subduction front to the Apulian collision front. Here we present an active tectonic study of Aitolo-Akarnania (Western Greece) that highlights how such a transition is accommodated in the overriding plate. Based on new multi-scale geomorphic and tectonic observations, we performed an accurate active fault trace mapping in the region, and provide evidence for active normal and left-lateral faulting along the Katouna–Stamna Fault (KSF), a 65-km-long NNW-striking fault system connecting the Amvrakikos Gulf to the Patras Gulf. We further show that the Cenozoic Hellenide thrusts located west of the KSF are no longer active, either in field observation or in GPS data, leading us to propose that the KSF forms the northeastern boundary of a rigid Ionian Islands-Akarnania Block (IAB). Cosmic ray exposure measurements of 10Be and 36Cl were performed on a Quaternary alluvial fan offset along the KSF (~50 m left-lateral offset). A maximum abandonment age of ~12–14 ka for the alluvial fan surface can be determined, giving an estimated KSF minimum geological left-lateral slip rate of ~4 mm year−1, in agreement with high GPS slip rates (~10 mm year−1). Despite this high slip rate, the KSF is characterized by subdued morphological evidence of tectonic activity, a gypsum-breccia bedrock and a low level of seismicity, suggesting a dominantly creeping behavior for this fault. Finally, we discuss how the IAB appears to have been progressively individualized during the Pleistocene (younger than ~1.5 Ma).