This paper reviews the options available for small island states to adapt to global environmental change, particularly climate change. Climate change may create new pressures for small island states (such as severe ocean acidification) and intensify others (such as sea-level changes) in a comparatively short, yet unpredictable, amount of time. Internal relocation and migration is a tested adaptation practice for such states, which already have well-established migration links. However, with greater access to financial resources – by increasing the extent to which island states profit from fishing or mining concessions, for example – and by investing in people and knowledge, states can reduce the need for future relocation.