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Small island developing states (or SIDS) are exposed to a large number of natural hazards and many characteristics of small island developing states make them particularly vulnerable to the impacts of natural hazards. In spite of this acknowledged vulnerability, there are relatively few studies which focus on the impacts of natural hazards in these countries. This paper presents a review of our current state of knowledge of impacts in small island developing states and highlights a number of research needs. Central to these is the need to integrate natural hazards research within a sustainable development context and the need to exploit existing procedures such as government coordinated disaster impact assessments to generate a detailed understanding of natural hazards impacts.