Noncommunicable diseases (NCDs) pose one of the biggest public health challenges in the Caribbean and were actioned politically in 2007 by the Caribbean Community through the Port of Spain Declaration. NCDs have usurped communicable diseases as the predominant cause of mortality globally, and the NCD “pandemic” is now being addressed worldwide. In this chapter, Omran’s updated epidemiologic transition and the Enhanced Chronic Care Model (eCCM) are used to describe the complex scenario in the English-speaking Caribbean (ESC), where NCD experiences, exposures to risk factors, and preventive actions are occurring in an ever-changing and evolving environment. This chapter provides country-specific examples and discusses the major NCDs and injuries in the Caribbean—namely cardiovascular disease, diabetes, cancers, and injuries (including violence)—their risk factors and impact on different demographic groups, as well as their economic and social effects. Prevention of morbidity and mortality from NCDs and injuries requires greater attention, increased funding, and coordinated action across the ESC involving all sectors and starting from the community level up to the national and international level to maintain the Caribbean way of life and promote health as a regional asset.