Small island developing states (SIDS) are among the first and worst affected by climate change. SIDS are thus also among the first to adapt, and as ‘early adaptors’ can provide key lessons for adaptation efforts elsewhere. This article reviews the growing literature on climate change, adaptation and small island states. It first discusses migration – which increasingly is seen as part of adaptation rather than a failure to adapt. Mobility has long been part of island life, and remittances can for example fund adaptation measures back home. Yet, adaptation in situ is not as forthcoming as would be necessary. The article identifies different barriers to effective adaptation, and discusses them under three distinct but interrelated categories: perceptions and awareness, institutions, and (lack of) resources. For effective, sustainable and successful adaptation, we need to overcome these barriers, and in particular provide information and resources to the local level. With appropriate information and resources, island communities can take and implement informed decisions and successfully adapt to a changing climate – as they have adjusted to social and environmental changes in the past.