Global warming of 1.5 °C above preindustrial levels and a commensurate increase in global greenhouse gas emissions pose an unprecedented danger to human settlements, livelihoods and the sustainable development of Small Island Developing States (SIDS), yet these challenges present tremendous opportunities to rethink development pathways. The paper has two objectives. One is to critically review present vulnerabilities and adaptation strategies employed by the state, private sector, non-governmental organisations, community-based organisations and households. The other is to discuss vulnerabilities and identify adaptation and resiliency strategies which are considered most applicable beyond the 1.5 °C limit. The Caribbean Region is the focus of the paper. A key finding of the paper is that temperature change above the 1.5 °C limit set by the Paris Conference of the Parties will make the natural and human systems of SIDS even more highly vulnerable than they are already. Another finding is that Caribbean states have implemented various innovative climate change adaptation strategies, but their relevance should the 1.5 °C target be exceeded, requires further exploration. The paper is useful to policymakers, decision-makers and finance agencies in search of practical solutions to avert the implications for Caribbean settlements, economies and ecosystems should the temperature warming exceed 1.5 °C.