In the Pacific island states, in addition to the traditional health issues common in developing countries, such as maternal and child health and communicable diseases, the increase in noncommunicable diseases (NCDs), e.g., obesity and diabetes, has become a serious problem. NCDs account for 80% of all deaths in this region, and the increase in early deaths of people younger than 70 years old is of particular concern. It has also been pointed out that the cost of countermeasures against NCDs are constricting government finances, and enhancing a health system that supports such countermeasures is also an urgent challenge. However, with respect to international health cooperation in Japan, the present status of NCDs and the associated statistical data in the Pacific island states are not likely to be addressed. Therefore, in this report, we comprehensively explain the present status of and approaches to NCDs around the world based on the World Health Organization (WHO), including those in the Pacific island states. By taking advantage of health indicators, we confirm the disease structure present in the 10 Pacific island states that cooperate bilaterally with Japan and then discuss the approaches in these states. As a result, although countermeasures against NCDs have been actively implemented in the Pacific island states in accordance with the WHO strategies, no tendency for the prevalence of NCDs to improve has been seen. To promote countermeasures against NCDs in the Pacific island states in the future, it will be necessary to engage in analysis and discussion of the present situation, to develop human resources, taking into consideration the region-specific characteristics of the islands, and to accumulate sufficient numbers of successful local stories consistent with the local strategies.