Small island states around the world are among the areas most vulnerable to climate change and sea level rise. In this paper, we present results from an innovative methodology for a quantitative assessment of multiple hazards on coastal risks, driven by different hydro-meteorological events, and including the effects of climate change. Moreover, we take an additional step by including in the methodology the option to assess and compare the effectiveness of possible disaster risk reduction measures. The methodology is applied to a real case study at the island of Ebeye (the Republic of the Marshall Islands). An example is provided in which a rock revetment is implemented as a risk reduction measure for the island. Results show that yearly expected damages may increase, by the end of the century, by a factor of three to four, depending on the sea level rise scenario considered, while the number of yearly affected people may double. Putting a cap on the temperature increase (e.g. 1.5 vs. 2 °C) according to the Paris Agreement may reduce damages and number of affected people by about 20 and 15%, respectively. However, impacts for same warming levels can vary substantially among different emission scenarios. Disaster risk reduction measures can be useful for mitigating risks in current and future situations but should be incorporated within long-term adaptive planning for these islands.