Pre-exposure prophylaxis (PrEP) involves the use of antiretroviral medication by individuals who are HIV-negative, aiming to lower the risk of acquiring HIV, especially for those at an elevated risk of contracting the virus. Despite WHO recommendations and high effectiveness, PrEP implementation has been slow in Pacific Island countries. To address the limited uptake of PrEP in Pacific Island countries and to support planning for potential PrEP implementation, this situational and feasibility assessment was conducted in 2023 in five Pacific Island countries (Kiribati, Republic of the Marshall Islands, Samoa, Tonga and Vanuatu).