The lack of access to modern energy services, sometimes also referred to as energy poverty, is a significant global development challenge. This paper provides an analysis of energy access in Small Island Developing States (SIDS), sheds light on current challenges and provides insights on opportunities to improve access to modern energy services in these countries. It provides an overview of energy access levels within the African, Caribbean and Pacific SIDS regions to refocus attention on their frail economies and dependence on imported fossil fuels. The focus here is on three specific factors that are still not well investigated: issues which relate to grid-extension, the lack of trained personnel for decentralised electrification and a high reliance on imported energy which drains Gross Domestic Product (GDP). A selection of SIDS case studies highlighting endeavours to expand energy access provide a basis on which key measures to expand electrification are suggested. Enabling conditions identified included a high level of commitment from the government and the setting up of an independent regulatory body with rulemaking and adjudicative powers. Additionally, the setting up of a cost-reflective tariff structure and appropriate fiscal framework are highlighted which can contribute towards electricity access expansion in island context.