The 2030 Agenda underscores the importance of a strengthened institutional framework at the national and regional levels that integrates the three dimensions of sustainable development. This study provides an overview of integrated decision-making processes in Caribbean countries and the role that national institutions play in supporting systematizing integrated decision-making for sustainable development, including in the implementation of the Sustainable Development Goals (SDGs), with focus on eight Caribbean Small Island Developing States (SIDS): Antigua and Barbuda, the British Virgin Islands, Dominica, Grenada, Jamaica, Saint Lucia, Saint Vincent and the Grenadines, and Trinidad and Tobago. The study identified some innovative good practices, scalable at the subregional level, designed to support integrated decision-making and coordinated implementation and follow-up of national and international development frameworks at all levels, as well as the mainstreaming of SDGs into national and subnational policies that are integrated across sectors. These practices may also help in improving the clarity of institutional roles and responsibilities among government agencies involved in the implementation of 2030 Agenda. All eight countries covered in this study have established or are in the process of establishing sustainable development frameworks, adopting the principles of multi-sector and inter-ministerial collaboration. Key elements of strategic integration at national level adopted by Caribbean countries include: Integrated development plans and strategies; Coordination mechanisms (Horizontal and Vertical); Participatory processes; Geographical Information Systems (GIS) and Access to information; Monitoring and Evaluation.