Pacific Island biodiversity has a notorious record of decline and extinction which continues due to habitat loss and degradation, invasive species, overexploitation, pollution, disease and human-forced climate change. In terrestrial systems, these global and local pressures are more acute because of relatively small land to sea area, high endemism and poor adaptations to resist predation. Regional policy and learning frameworks exist to combat biodiversity loss and environmental degradation, but implementation remains patchy across the 22 Pacific Island countries and territories (PICTs) within Oceania. PICTs are challenged by small, under-resourced government departments, limited data, and strong political will for rapid economic development at the cost of ecological sustainability. In this synthesis of the special issue, we identify the challenges and opportunities for biodiversity conservation on Pacific islands. We identified bright spots of implementation occurring through regional initiatives, knowledge-sharing networks, and community-based management. The challenge looms large, given the relatively small-scale efforts compared to the core drive for development of natural resources which continues to pervade island communities. Five key initiatives promise improved conservation effectiveness: 1) alignment of national biodiversity strategies to the Aichi Targets, under the Convention on Biological Diversity; 2) increased engagement with local communities to promote wise stewardship and local environmental monitoring; 3) dissemination of best practice guidelines for management through learning networks; 4) cost-benefit analyses that drive investment in biosecurity and invasive control; and 5) implementation of integrated island management that accounts for the multiple synergistic benefits of ecosystem management (e.g., climate adaptation, disaster risk reduction, improved health).