From islands with no permanent flowing streams to those with navigable inland waters, the insular Caribbean contains a great range of conditions regarding the access to freshwater resources. Because of the variation in topography and size, the ability of islands to retain freshwater also varies widely. The usage of freshwater in this region is being led by two major drivers: (1) the demands of basic water needs from an increasing urban population, and (2) those of tourism-based economies that demand water for recreation and aesthetic uses. Formal and informal freshwater management and conservation approaches vary from those being implemented at an individual level based on cultural practices, to those based on government programs. Although most islands have integrated watershed resources practices at some level, Economic investment in infrastructure and social governance of water and environment need further evaluation and development. In this overview paper, a description of the natural environment associated to freshwater resources in the insular Caribbean is presented, noting also economic and climatic constraints. Opportunities for improvement in the management of Caribbean freshwater resources are discussed in light of the particular regional environmental context.