As the impacts of climate change increase, Small Island Developing States (SIDS) in particular shall face increasingly significant adaptation challenges. Past climate adaptation efforts within SIDS have had limited success. As such, the purpose of this systematic literature review has been to identify areas of importance for facilitating climate adaptation, particularly within Small Island Developing States (SIDS), and more specifically, to assess the extent to which participatory justice within decision-making processes is recognised as an important component of climate adaptation through the lens of water management. This review process utilised the SPIDER tool to guide the literature search across SCOPUS, Web of Science and EBSCO host databases, generating 495 publications that were reduced to a total of 70 sources guided by PRISMA, informing the review’s results and discussion. Thematic analysis of the selected studies was applied, utilising the Values-Rules-Knowledge framework. Through this analysis, five principles were created and comprise the major conclusions of this review: (1) ensuring community engagement, (2) expanding available options through local experimentation, (3) ensuring that monitoring and evaluation of adaptation initiatives are taken seriously, (4) adopting decision-making mechanisms that are systems-oriented and inclusive, and (5) investing only if there is a long-term commitment to protecting SIDS. It is hoped that these principles can serve as a comprehensive guide for funding agencies, applied projects and research aiding climate adaptation within SIDS.