Climate change is projected to increase temperatures, sea level rise and extreme weather events. Children living in remote, low-lying Pacific Islands are particularly at risk from the impacts of climate change, due to their physical, environmental and socio-economic vulnerability. The objective of this paper is to examine the potential health effects of climate change and climate change related migration on children in rural and remote areas, especially those living in the Pacific Islands. A review of the literature on climate change health impacts in rural and remote areas was conducted, focusing on those living in the Pacific Islands and on climate change related migration. The results suggest climate change is likely to increase heat related and extreme weather related mortality and morbidity and increase infectious disease incidence and transmission in the Pacific Islands, especially in children. Climate change is also likely to impact indirectly on child health by affecting water, food and financial security and by increasing inequalities. By 2050, approximately 235,000 people on Kiribati, 20,000 people on Tuvalu and 800 people on Tokelau are likely to be at high risk of climatechange-related migration and the adverse impacts this can have on mental, physical and social health. Climate change is likely to have a significant impact on the health of children living in rural and remote areas, such as the Pacific Islands. It is therefore imperative that resources are targeted to enhance the adaptive capacity of these areas.