The climate crisis poses a grave threat to numerous small island developing states (SIDS), intensifying risks from extreme weather events and sea level rise (SLR). This vulnerability heightens the dangers of coastal erosion, chronic water quality degradation, and dwindling coastal resources, demanding global attention. The resultant loss of ecological persistence, functional services, and ecosystem resilience jeopardizes protection against wave action and SLR, endangering coastal habitats’ economic value, food security, infrastructure, and livelihoods. Implementing integrated strategies is imperative. A thorough discussion of available strategies and best management practices for coastal ecosystem restoration is presented in the context of SIDS needs, threats, and major constraints. Solutions must encompass enhanced green infrastructure restoration (coral reefs, seagrass meadows, mangroves/wetlands, urban shorelines), sustainable development practices, circular economy principles, and the adoption of ecological restoration policies. This requires securing creative and sustainable funding, promoting green job creation, and fostering local stakeholder engagement. Tailored to each island’s reality, solutions must overcome numerous socio-economic, logistical, and political obstacles. Despite challenges, timely opportunities exist for coastal habitat restoration and climate change adaptation policies. Integrated strategies spanning disciplines and stakeholders necessitate significant political will.