Expected effects of changes in global climate include warmer temperatures, rising sea levels, and potentially more frequent and severe extreme weather events such as hurricanes and tropical storms. Low-lying states in the Caribbean are especially vulnerable to these effects, posing significant risks to public safety and natural resources. This paper highlights expected trends in the Eastern Caribbean and examines the impacts of urbanization and supporting infrastructure, siting of major structures in high-hazard areas, and negative land-use practices on fragile coastal ecosystems. It focuses on the need to reduce the vulnerability of coastal infrastructure and land uses, arguing for effective linkages between climate change issues and development planning. The paper also provides general recommendations and identifies challenges for the incorporation of climate change impacts and risk assessment into long-term land-use national development plans and strategies.