Integrated Island Management (IIM), aims to respond to the unique circumstances of small island ecosystems through development of holistic integrated management systems that operate at the scale of ecological, social or physical processes within, and to, islands. This document results from efforts to identify guiding principles for IIM in the Pacific. A short description of commonly used terms for other environmental management approaches is provided. This is followed by a brief description of ten guiding principles for maximizing effectiveness of IIM projects. Fifteen case studies from the Pacific region are highlighted to illustrate application of these guiding principles. Identified lessons learned and over over-riding considerations and recommendations are given such as: ensuring sustainability of human and financial capacity for ecosystem management projects; incorporating considerations of future climate change scenarios into IIM planning; and planning simultaneously for environmental outcomes and public health benefits.