In the vast tropical Pacific Basin islands, corals reef ecosystems are one of the defining marine habitats, critical for maintaining biodiversity and supporting highly productive fisheries. These reefs are also vital for tourism and armoring exposed shorelines against erosion and other storm-related effects. Since the 1980's, there has been growing evidence that these Pacific Basin coral reef ecosystems are highly vulnerable to the combined effects of both climatic and non-climatic stressors. Observations of widespread bleaching in the region has been linked to acute temperature stress, and the heightened recurrence intervals and intensity of storms has been correlated to recent climate-change induced impacts. Ocean acidification is another ubiquitous stressor with dramatic consequences to biological systems. In this paper we describe what sets this region apart from other coral reef regions around the world, and highlight some examples of the diverse response to ocean acidification threats and associated socio-economic impacts. (c) 2019 Published by Elsevier B.V.