Small island developing states such as Kiribati in the Equatorial Pacific are among the most climate vulnerable places on Earth. While there is a considerable body of literature on the scale of the problem, there is very little research on the lived experiences of communities, their concerns and priorities, and how they are coping with environmental and climate hazards. As a result, a top-down approach is often adopted in adaptation projects that may not meet the real needs of communities, endangering the long-term sustainability and viability of interventions. Through a series of participatory focus groups carried out in Kiribati in 2019, this study explores what communities prioritise and wish to see implemented to cope and build resilience to present and foreseeable future challenges. The outcomes of this research show environmental risks and hazards faced by communities are strongly associated with climate projections. Communities are currently trying to adapt to challenges, both old and new, with technologies and materials available. While there is a degree of spontaneous adaptation occurring, these problems are insurmountable without solving present challenges in Kiribati, such as access to better technology and markets without becoming over-reliant. Including communities in co-designed interventions can also ensure sustainability in climate adaptation projects. The findings of this research can inform policy and climate change adaptation measures in other similar atoll islands in the Pacific.