Island nations such as Barbados, Jamaica, and Tonga face rising threats from climate change, including hurricanes, flooding, and sea-level rise. Nurses and midwives are crucial frontline responders, leading disaster preparedness, emergency care, and community recovery. This paper highlights their leadership, resilience, and innovation in addressing the health impacts of climate-related disasters. Drawing on realworld examples, it shows how these professionals bridge clinical care with public health strategies, ensuring vulnerable populations receive timely, culturally appropriate interventions. Through education, emergency planning, and clinical support, they foster resilience and recovery. The experiences from these islands emphasize the urgent need to strengthen nursing and midwifery leadership within climate adaptation efforts. Recognizing and investing in their role is vital to building sustainable, climate-resilient health systems in Small Island Developing States (SIDS). The paper calls for increased policy support, funding, and capacity-building to empower nurses and midwives as essential agents of change.