Coral reefs in the tropical Pacific region are exposed to a range of anthropogenic local pressures. Climate change is exacerbating local impacts, causing unprecedented declines in coral reef habitats and bringing negative socio-economic consequences to Pacific communities who depend heavily on coral reefs for food, income and livelihoods. Continued increases in greenhouse gas emissions will drive future climate change, which will accelerate coral reef degradation. Traditional systems of resource governance in Pacific island nations provide a foundation to address local pressures and build reef resilience to climate change. Management and adaptation options should build on the regional diversity of governance systems and traditional knowledge to support community-based initiatives and cross-sectoral cooperation to address local pressures and minimize climate change impacts. Such an inclusive approach will offer enhanced opportunities to develop and implement transformative adaptation solutions, particularly in remote and regional areas where centralized management does not extend.