Pacific countries are sovereign nations with distinctive histories, ethnicity, customs, primary resources, economies, and health systems. Despite these and other acknowledged differences, similarities exist in many areas such as geography, legal history, and culture. Many share the experience of colonization, with imported British laws and the subsequent experience of independence. Most Pacific countries are also developing countries. This article broadly describes approaches to legislating in public health in Papua New Guinea, Fiji, Vanuatu, and the Solomon Islands and notes common elements in their public health laws, in particular, in relation to administration, allocation of powers and responsibilities, interaction with local government, communicable disease control, and nuisance. The article concludes that many Pacific public health laws could deliver better support for current health policy, more sensitivity to the culture and customs of the region, and better management of public health risk through laws that are better suited to their Pacific environment, easier to understand, more flexible, and more relevant to current health policy.