The insular Caribbean is among the few oceanic-type island systems colonized by non-volant land mammals. This region also has experienced the world's highest level of historical mammal extinctions, with at least 29 species lost since AD 1500. Representatives of only 2 land-mammal families (Capromyidae and Solenodontidae) now survive, in Cuba, Hispaniola, Jamaica, and the Bahama Archipelago. The conservation status of Caribbean land mammals is surprisingly poorly understood. The most recent IUCN Red List assessment, from 2008, recognized 15 endemic species, of which 13 were assessed as threatened. We reassessed all available baseline data on the current status of the Caribbean land-mammal fauna within the framework of the IUCN Red List, to determine specific conservation requirements for Caribbean land-mammal species using an evidence-based approach. We recognize only 13 surviving species, one of which is not formally described and cannot be assessed using IUCN criteria; 3 further species previously considered valid are interpreted as junior synonyms or subspecies. Of the 12 reassessed species, 5 have undergone a change in threat status since 2008, with 3 species (Capromys pilorides, Geocapromys brownii, Mesocapromys angelcabrerai) increasing in extinction risk by 1 IUCN category, and 2 species (Plagiodontia aedium, Solenodon paradoxus) decreasing in extinction risk by 2 categories. Only 1 change in threat status represents a genuine change; all other changes are mainly associated with new information becoming available. Hunting, habitat loss, and invasive species represent major threats to surviving species, and conservation of the highly threatened Caribbean land-mammal fauna will require a range of targeted management strategies.