This publication provides a summary of the Food and Agriculture Organization's (FAO) activities and accomplishments in the Pacific Islands region between 2018 and 2022. FAO's Pacific Multicountry Programming Framework 2018-2022 has guided the work in the region through three key outputs aimed at promoting sustainable agriculture and food security while aligning with the UN's sustainable development agenda. Countries’ efforts have included promoting local food production, climate and disaster resilience, healthy diets, and gender equity in the agriculture sector. Results were also achieved by improving coastal fisheries, creating business and marketing opportunities for small-scale farmers, and strengthening national capacities for data collection and analysis. This publication serves as a reflection of past achievements and a call for continued collaboration in the years to come.