In recent years there has been considerable research attention directed at understanding the economic performance of sovereign very small states, many of which are also islands. This paper reviews the theoretical and conceptual arguments concerning the different challenges which small states and island economies face within an increasingly globalised system. The empirical evidence drawn from previous research by the authors stands in direct contrast to the theoretical literature. Very small states are shown to have performed generally very well and their economic performance is as good as, and often better, than that of larger states. Interestingly, whether a very small state is an island or not appears to have virtually no influence upon subsequent economic performance. The paper concludes with a comparison of very small states and non-sovereign island economies within Western Europe. Sovereign small states (whether islands or not) generally perform better than their non-sovereign island counterparts in Western Europe. The pattern is not, however, a uniform one. Some non-sovereign islands in Western Europe, particularly those able to develop summer vacation tourism activity have performed well.