Assessing the vulnerability of low-lying coral reef islands is a global concern due to predictions that climate and environmental change will increase reef island instability and cause reef island populations to be among the first environmental refugees. Reef islands in the Pacific and Indian Oceans are highly dynamic environments that morphologically adjust to changing environmental conditions over annual-decadal timescales. However, there is a paucity of reef island shoreline change data from the Caribbean where sea-level rise, ecological and environmental disturbance and hydrodynamic regimes are considerably different than in other oceans globally. Here we present shoreline change analysis of 16 reef islands in northern Honduras, at the southern end of the Mesoamerican Barrier Reef. Satellite imagery from a maximum period of 12.4 years from Utila (2006–2019), and 2.4 years from Cayos Cochinos (2018–2021) was analysed to quantify island shoreline change and planform morphological adjustments. We identified accretion as the dominant island behaviour in Utila, where 5 of 7 islands increased in area and 61.7% of shorelines accreted, contributing to an overall net area increase of 9.4%. Island behaviour was more variable in Cayos Cochinos, where 55.7% of shorelines eroded, 5 of 9 islands remained stable, and net island area change was insignificant (2%). Conversely, the 4 smallest Cayos Cochinos islands (all <1500 m 2) experienced significant shoreline change, potentially highlighting a new size threshold for considering reef island evolution. Across both sites, reef islands demonstrated a range of modes of planform change, including lateral accretion and erosion, and migration. Consequently, we provide the first empirical evidence of the dynamic nature of Caribbean reef islands during a period coincident with sea-level rise and highlight the heterogeneous nature of reef island evolution between and within two neighbouring sites at timescales relevant for island adaptation efforts.