Drought is known as a “creeping disaster” because drought impacts are usually noticed months or years after a drought begins. In the Pacific Island Countries and Territories (PICTs), there is almost no ability to tell when a drought will begin or end, especially for droughts other than meteorological droughts. Monitoring, forecasting and managing drought in the PICTs is complex due to the variety of different ways droughts occur, and the diverse direct and indirect causes and consequences of drought, across the PICT region. For example, the impacts of drought across the PICTs vary significantly depending on (i) the type of drought (e.g. meteorological drought or agricultural drought); (ii) the location (e.g. high islands versus atolls); (iii) socioeconomic conditions in the location affected by drought; and (iv) cultural attitudes towards the causes of drought (e.g. a punishment from God versus a natural process that is potentially predictable and something that can be managed). This paper summarises what is known and unknown about drought impacts in the PICTs and provides recommendations to guide future research and investment towards minimising the negative impacts of droughts when they inevitably occur in the PICTs.