The growth prospects of the Small Island Developing States (SIDS) are stalled by various influences including coastal and marine ecosystems degradation, sea-level rise, impacts of climate change and natural disasters, demographic trends, and increasing water-food-energy needs. This chapter presents critical aspects of policy and institutional analysis that are relevant to water security and disaster risk management (DRM) for SIDS. Towards this objective, local, national, and international regulatory frameworks applicable to SIDS are analysed with comments on gaps and needs in water management within the context of DRM. Additionally, the programmes and projects with the SAMOA Pathway are examined. The chapter explores the potential for SIDS establishing integrated development planning and better implementation of the Sustainable Development Goals (SDGs) agenda, particularly SDG 6. In the closing section, a smart strategy (Ten-Point Agenda) is proposed as a guideline to transform theory on water security into effective action.