Communities throughout the Pacific Islands region have experienced, and will continue to experience, extensive non-economic loss and damage (NELD) from climate change. Assessments of loss and damage, however, often fall short on their coverage of these non-economic dimensions, which can distort our understanding of climate change impacts, discount the experiences of some and skew future decision-making. This paper explores how stakeholders in the Pacific Islands understand NELD and what they perceive to be the best ways of responding to it. An open-ended questionnaire was used to collect qualitative and quantitative data from representatives from governments, donors and development partners, civil society, intergovernmental organisations, and relevant others. This study found that NELD in the Pacific Islands is understood, perceived and experienced through the lens of intangible values, identity and cultural landscapes, and this is encapsulated by a typology with eight interconnected core dimensions. These eight dimensions include: health and wellbeing, ways of being, future ways of being, cultural sites and sacred places, Indigenous and local knowledge, life sustaining tools, biodiversity and ecosystem services, and connection to land and sea. NELD is complex, entangled and interconnected, thereby significantly undermining entire socio-ecological systems. Moving forward, responding to NELD in the Pacific Islands region will require a comprehensive approach that protects, conserves and restores complex socio-ecological systems, and provides opportunities to work through loss and damage by means of education and training, safeguarding knowledge systems, community activities, cultural connection and maintenance, and strong relationships with land and sea.