This book reviews the access to services, investment needs, tariffs, and efficiency of fifteen Caribbean countries across five infrastructure sectors (telecommunications, electricity, water and sanitation, maritime transport and ports, and airports and air services). Benchmarks are established to compare Caribbean countries with each other, and with similar countries. To some extent, differences in performance can be explained by unalterable factors such as a given country's size and location. However, we find that, in many cases, differences in performance among countries cannot be completely explained by such factors. Many of the remaining differences seem to be attributable to institutional and policy factors, such as the level of competition among service providers within a given sector, whether providers are government or privately-controlled, and the quality of regulatory and subsidy regimes. The study highlights several key policy findings and recommends changes that have the potential to help Caribbean governments overcome some of their inherent disadvantages of scale to provide better, cheaper infrastructure services.