The Caribbean faces inexorable climate change during the 21st century. This phenomenon will have a profound effect on the long-term sustainable socioeconomic development of the islands and is likely to jeopardize achievement of the Millennium Development Goals. All economic and social sectors will be adversely affected. The water resources sector on most islands is one that will be strongly impacted by climate change. Against a background of increasing demand for potable water, sea-level rise may lead to flooding of lowlands and seawater intrusion into coastal aquifers, while variability in climate may see more intense rainstorms resulting both in increased run-off leading to increased flooding and reduced recharge leading to aquifer depletion. Such impacts will have a negative ripple effect on other vital aspects of regional economies such as the tourism, recreational, agricultural and industrial sectors. Unfortunately, adequate management of water resources on many Caribbean islands is sorely lacking. In many cases baseline data that may be used to track changes is sparse or non-existent. This paper explores the probable effect climate change will have on water resources in the Caribbean, the fall-out from these effects and strategies for mitigating potential negative impacts.