Climate change adaptation (CCA) is seen as being particularly important for one island region defined within international development: the Small Island Developing States (SIDS). This chapter explores CCA governance for SIDS, both with and without government. All development activities are imbued with power relations, lessons which apply to CCA, which includes power relations among genders, ages, ethnicities, religions, sexualities, physical and mental abilities, subject disciplines, institutions and governance bodies. For CCA governance on SIDS, different degrees of conflict and cooperation are presented among the parties involved in different case studies. SIDS governments should not necessarily be blamed for any deficiencies in national governance due to the challenge of small-scale and limited resources. With some SIDS having populations in the tens of thousands, it is unrealistic to expect to find a civil servant conversant in every aspect of CCA; hence, the need for pooled governance as part of inter-SIDS cooperation.