The Pacific region covers a third of the Earth’s surface and is home to thousands of islands. Isolated Pacific island ecosystems are highly vulnerable to external disturbances. Habitat destruction and invasive alien species are just two of many threats to native plants. The New York Botanical Garden has a longstanding tradition of research programs in the Pacific Region. These programs combine efforts to complete botanical inventories of these islands, which harbor a rich array of endemic plant species, and to identify the most important places for conservation. At the same time, indigenous knowledge about plants is integrated into conservation efforts that preserve both traditional medicinal practices and the botanical resources upon which they depend.