Background and Objective: Ciguatera Fish Poisoning (CFP) is the most common seafood-borne intoxication, affecting around 50000 people annually, mostly in tropical coastal areas. It is caused by toxins released by microalgae whose proliferation is promoted by ocean warming, coral bleaching and anthropogenic disturbances. Small Island Developing States are exposed to severe productivity losses and deprivation of food sources as a Results of CFP. However, they show scarce awareness, hindering appropriate preventive behavior, risk management strategies and formal case reporting. The objective of this study is to estimate CFP incidence in three Caribbean islands (Guadeloupe, Martinique, Saint Lucia), assess its economic impact in terms of health costs and productivity loss and the awareness level in both residents and tourists. Methods: Economic data will be collected through hospital databases and supplemented with interviews with healthcare professionals and managers. Incidence will be estimated through disease notifications and survey data. Two questionnaires were designed to assess knowledge, behavior and intentions concerning CFP. A reliability analysis, and descriptive and inferential statistics will be applied to the responses. Results: The fisherman survey comprises 57 questions regarding: respondents’ general characteristics (14), CFP-related personal experiences (20), knowledge (9), behavior (11) and intentions (3). The tourist version includes 43 questions on: respondents’ general characteristics (5), CFP-related personal experience (19), knowledge (9), behavior (7), intentions (3). In February – April 2023, both surveys will be administered to a convenience sample and economic data will be extracted. Preliminary results will be available in May 2023. Conclusions: The estimated incidence is expected to differ from that available in literature due to the lack of formalized case reporting and awareness. A higher level of awareness is expected among residents rather than tourists. Findings will provide a novel contribution to research and inform policy decisions, especially considering CFP projected expansion.