Small islands are of special interest for sustainable development because of their unique characteristics and vulnerabilities. They are ecologically fragile, have limited resources, are susceptible to natural disasters and climate change. This study reviews the literature on island ecosystems, their contribution in the delivery of five key Island Ecosystem Services (IES) and acting pressures and trade-offs associated with IES management. From a set of 1630 potential relevant papers, 273 were selected for analysis. Most of the selected papers focused on cultural IES, in the form of recreation, eco-tourism and gene pool protection. However, provisioning and regulating IES were also well represented in the literature. Most of the studies discussed different management strategies and pressures arising from human use of IES. A small subset investigated the links between island biodiversity and IES, and the contribution of IES to human well-being. This review highlights knowledge gaps in the literature and identifies the need to develop approaches for IES assessments that are informed by local knowledge and which make use of empirical and spatial data for management that maximises the potential of island ecosystems to deliver IES whilst reducing trade-offs.