The intent of this paper is to place the concepts of exposure, vulnerability, resilience and risk in the context of the consequences of global change for the sustainable development of small island developing states (SIDS). Many such states face a number of global climate change risks, such as an increase in the proportion of more intense storms, along with other global change threats that include energy security and costs. All these threats come on top of local development threats, such as increased run-off, often with increasing levels of contaminants due to unsustainable agricultural and industrial practices. When taken together, the resulting pressures on islands and their communities lead to significant increases in vulnerability to change due to reduced resilience to these changes. Vulnerability is also increasing as a result of contemporary processes that heighten the exposure of material and other assets. The capacity to address hazard risk also influences vulnerability. This includes the level of awareness of coastal hazards and exposure, and access to critical life support infrastructure, especially for people living in hazard-prone areas. Vulnerability and resilience are considered to be important integrating concepts when managing the local consequences of global changes. There are many initiatives that will help reduce the vulnerability and enhance the resilience of SIDS to such changes. These include improving risk knowledge and coastal resource and land use management, while also strengthening socio-economic systems and livelihoods. In this way, managing global change can be closely aligned with local development and humanitarian processes, thereby enhancing the overall sustainability of development processes and outcomes.