The wetlands of 21 countries and territories of the Pacific Islands region are reviewed: American Samoa, Cook Islands, Federated States of Micronesia, Fiji, French Polynesia, Guam, Kiribati, Marshall Islands, Nauru, New Caledonia, Niue, Northern Mariana Islands, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu, Vanuatu, and Wallis and Futuna. The regions’ wetlands are classified into seven systems: coral reefs, seagrass beds, mangrove swamps, riverine, lacustrine, freshwater swamp forests and marshes. The diversity of species in each of these groups is at near global maxima at the west of the region, with decline towards the east with increasing isolation, and decreasing island size and age. The community structure is unique in each country, and many have endemic species with the habitat isolation that epitomises this island region. There remain, however, some serious gaps in basic inventory, particularly in freshwater biodiversity. Threats to wetlands include introduced freshwater species, loss of wetlands adjacent to urban growth, downstream effects of mining and land clearance, and over-use of mangrove, seagrass and coral reef resources by predominant subsistence economies that remain in this region. Only five countries are signatories to the Ramsar convention on wetlands, and this only recently with seven sites. Wetland managers have identified the need for community education, baseline surveys and monitoring, better legislation and policy for wetland management, and improved capacity of local communities to allow the wise use of their wetlands.