The countries and territories of the Pacific Islands face many challenges in building the three main pillars of food security: availability, access and appropriate use of nutritious food. These challenges arise from factors including rapid population growth and urbanization, shortages of arable land for farming and the availability of cheap, low-quality foods. As a result, many are now highly dependent on imported food, and the incidence of non-communicable diseases in the region is among the highest in the world. This report summarizes: 1) the projected effects of climate change on agriculture, fisheries and aquaculture in the Pacific region; 2) adaptations and supporting policies needed to reduce risks to food production; 3) gaps in knowledge that must be filled in order to implement the adaptations effectively; 4) recommendations to fill these knowledge gaps.