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Micro, small, and medium-sized enterprises (MSMEs) play a significant role in economic development in Pacific island countries and offer pathways to women’s leadership and economic empowerment. This report explores the state of knowledge on women’s economic empowerment in the region, focusing on women’s entrepreneurship and MSMEs owned by women. Drawing on over 200 published papers and studies and 11 quantitative datasets, it analyzes drivers of—and barriers to—women’s economic empowerment. It looks at business ownership, formalization, and expansion; violence against women and girls; and the effects of the COVID-19 pandemic. The report provides recommendations for research, policy, and programming.