Accessing abortion services is challenging in many countries around the world. Barriers often result from a combination of factors, including poor access to healthcare, geographic location, legal restrictions, abortion stigma, and moral conservatism. Repeated studies have indicated that restricting access to abortion does not prevent it happening, but rather displaces it elsewhere and often results in unsafe abortion contributing to maternal mortality. Those living on islands face particular challenges presented by the geographic isolation that often necessitates travelling to other jurisdictions, which is financially and emotionally burdensome. This collection of essays shines a light on two islands--Ireland (north and south) and Prince Edward Island, Canada--and considers for each island why and how abortion remains restricted, the nature of the discourse of abortion on the island, the impact that restrictions have had, on-going efforts to improve access, and recent activist successes.