Low-lying atoll countries face existential threats from climate change, including sea-level rise, freshwater contamination, and coastal erosion. This review examines artificial island development as a transformational adaptation strategy for four atoll countries (the Maldives, Kiribati, the Marshall Islands, and Tuvalu) through a comparative analysis evaluating technical, financial, legal, and governance dimensions. Our findings reveal that artificial island development is technically achievable, as demonstrated by the Maldives’ Hulhumalé project, which has created approximately 4 km² of elevated land at twice the elevation of natural islands. However, implementation feasibility varies substantially across nations depending on governance structures and land-tenure systems. Centralized state ownership in the Maldives enables rapid implementation, while customary land tenure in Pacific nations presents significant barriers. Financial requirements vastly exceed domestic fiscal capacities, with estimated adaptation costs ranging from hundreds of millions to billions of U.S. dollars, necessitating substantial international climate finance. The review identifies critical environmental trade-offs, because dredging operations damage coral reef ecosystems, which provide natural coastal protection, and highlights unresolved legal uncertainties under the United Nations Convention on the Law of the Sea (UNCLOS) regarding maritime zones and sovereignty preservation. Despite these challenges, artificial islands offer a pathway to honor atoll communities’ “right to stay” in their homelands, although successful implementation requires integrated governance reform, sustained international financing, and environmental safeguards in addition to engineering solutions.

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