Local and Indigenous knowledge systems worldwide indicate adaptation and mitigation strategies to climate change. Particularly in regions that are massively affected by climatic changes, such as the Pacific Island States, there is a need for increased and combined research on the role which these knowledge systems can play internationally. For this reason, this article provides a synthesis of empirical results and approaches to local and Indigenous climate change adaptation and mitigation strategies in selected South Pacific Island States by using a meta-ethnographic approach. The reviewed literature is associated with the sub-disciplinary perspective of the Anthropology of Climate Change. The results of the meta-ethnographic analysis are discussed based on three thematic focal points: First, the empirical ground of local understandings of climate change and its theoretical conceptualization(s) are constituted. Second, the results of practices for adaptation to climate change are synthesized and presented in detail throughout one example. Third, the synthesis of climate change mitigation practices is outlined with a specific focus on human-environment relationships.