This book provides a contemporary overview of the social-ecological and economic vulnerabilities that produce food and nutrition insecurity in various small island contexts, including both high islands and atolls, from the Pacific to the Caribbean. It examines the historical and contemporary circumstances that have accompanied the shift from subsistence production to the consumption of imported, processed foods and drinks, and the impact of this transition on nutrition and the rise of non-communicable diseases. It also assesses the challenges involved in reversing this trend, and how more effective social and economic policies, agricultural and fisheries strategies, and governance arrangements could promote more resilient and sustainable small island food systems. It offers both theoretical and practical perspectives, and brings together a broad range of policy areas, e.g. agriculture, food, commerce, health, planning and socio-economic policy. Given its scope, the book offers a valuable resource for a range of disciplines in a number of regional contexts, and for the growing number of scholars and practitioners working on and in small island states. It will be of particular value as the first book to examine the diversity and commonalities of island states around the globe as they confront issues of food security.