This paper describes the main challenges that Small Island Developing States (SIDS) are expected to face from climate change and possible responses to those challenges. The main impacts on SIDS from climate change are from air and sea temperature increases, changes to precipitation and storms, and ocean acidification, which in turn have major impacts on ecosystems, freshwater, and the natural resources on which islanders depend. SIDS people would prefer to stay in their communities by adjusting to the changes, but they need external support for doing so. As such, climate change is a global challenge but also needs to be placed in wider development and sustainability contexts to ensure that more problems are not created or exacerbated.