Island waste management professionals are faced with limited land resources, high energy costs, large seasonal fluctuations in waste volumes, and complex social and political dynamics that stem from their often closely knit societies. These and other factors can discourage typical waste management practices, but they also provide opportunities for island governments and businesses to explore alternative technologies and policies that suit their particular circumstances and that might be environmentally preferable. This critical review discusses the waste management literature on islands to date, including several industrial ecology (IE) studies. Common advantages and disadvantages faced by island waste management challenges are presented from the perspectives of business and municipal management. Waste generation data are presented from more than 40 islands around the world and tested for correlation with economic and geographic parameters and using cluster analysis, with the aim of identifying trends among island types. Poor data quality and comparability are ongoing challenges that underscore the potential benefits of a consistent program of island waste management data collection. Finally, the review explores opportunities for applying IE research to generate useful insights and policies in the areas of material flow analysis, industrial symbiosis, life cycle assessment, and social ecology.