As the Small Island Developing States of the Caribbean prepare to take climate change adaptation measures, there is a distinct possibility that the most vulnerable groups, especially the poor, women, indigenous, elderly, and children in rural and coastal communities are at risk of being marginalized. It is necessary to take into consideration the adaptation needs of these groups that are likely to be disproportionately affected due to inherent structural and social disparities. In this paper we focus on the need to ensure inclusion and social equity in adaptation planning as climate change issues disproportionately impact health, settlement, and livelihoods of these vulnerable groups. We also focus on climate change potential impacts on tourism, agriculture and fisheries sectors, which are the major economic drivers of these island states. Based on Caribbean region wide observations, we recommend priority areas including increasing community participation, local initiatives and filling critical socio-economic and livelihood data gaps, which policy makers need to focus on and incorporate in their climate change adaptation plans in order to ensure effective and equitable climate change adaptation