Pacific Island countries, like the Cook Islands, are often considered to be extremely vulnerable to the impacts of climate change. Considerable literature highlights that local knowledge can play an important role in climate change adaptation, particularly in small island countries. However, there is less understanding on how to practically integrate and apply local knowledge in climate change adaptation, particularly in the Cook Islands. This research investigated the role of local knowledge in climate change adaptation in the Cook Islands, aiming to understand the role of local knowledge in adaptation policies and the challenges of incorporating local knowledge into climate change adaptation policy through semistructured interviews with key informants and local participants. Key informants often recognized the important role of local knowledge in climate change adaptation while local knowledge was less recognized by local participants. Concerns over both the usefulness of the knowledge today and the loss of this knowledge were expressed. Additionally, challenges to integrating local knowledge into climate change policy were identified, including development pressure, out-migration, and a lack of understanding of local knowledge. This study offers insight into the role of local knowledge in climate change adaptation for other small island countries facing similar challenges.