This research examines tourism within developing island states in the Indian Ocean that will be at extreme risk from the impacts of climate change. Many have a high economic reliance upon tourism and yet will be adversely affected by both higher sea levels and raised water temperatures. However, many developing islands utilise tourism as a vector for economic growth and ironically they too tend to be some of the first destinations to observe possible impacts of climate change like the disappearance of beaches and the greater intensity of storms. Destinations in the developing world are extremely concerned that tourists from developed countries will reduce the number of long haul flights they take to ameliorate their carbon footprint. Three tourism island destinations in the Indian Ocean are used as case studies, namely Sri Lanka, the Maldives and the Seychelles. The research seeks to establish the knowledge levels and actions of public and private sector stakeholders within the tourism industry in response to the impacts of climate change within these island destinations. A multi-method approach is used to gather data: semi-structured interviews, participant observations and documentary evidence. This is useful for the purpose of triangulation and to increase the construct validity of the research. The findings build a detailed picture of the cases and enable an understanding into the respondents’ knowledge of climate change; climate change adaptation and mitigation measures taken or planned within the destination; current and future impacts of climate change and how the tourism industry has responded. This provides an insight as to whether sustainable tourism policies are being encouraged, adaptation and mitigation measures taken or planned and also an assessment of the effectiveness of transfer from policy to practice. The results illustrate that all the destinations are currently experiencing changes which they associate with climate change; these impacts vary within each of the destinations. Contextual factors identified as being significant in understanding the responsiveness of tourism island destinations to climate change within the Indian Ocean were the unique political, economic, social, geographic and technological aspects of each island. These contextual factors influenced the stakeholders’ knowledge, attitude and behaviour regarding climate change. This provides an indication of the tourism islands’ preparedness for the consequences of climate change and an indication of the future of tourism on the islands. Based on the analysis of the findings a model is proposed that seeks to explain the relationship between these factors that will provide an indication of the future shape of tourism on these Indian Ocean island tourism destinations.