The insular Caribbean has experienced the world’s highest levels of historical mammal extinctions, with at least 29 species lost since AD 1500. Representatives of only two non-volant land mammal families (Capromyidae and Solenodontidae) now survive, and the conservation status of these is surprisingly poorly understood. In the 2008 IUCN Red List assessments 15 endemic species were recognised, of which 13 were assessed as threatened. We reassessed all available baseline data on the current status of these species within the framework of the IUCN Red List, to determine their specific conservation requirements using an evidence-based approach. We now only recognise 13 surviving species, one of which is not formally described and cannot be assessed using IUCN criteria; three further species previously considered valid are interpreted as junior synonyms or subspecies. Of the 12 reassessed species, five have undergone a change in threat status since 2008, with three species (Capromys pilorides, Geocapromys brownii, Mesocapromys angelcabrerai) increasing in extinction risk by one IUCN category, and two species (Plagiodontia aedium, Solenodon paradoxus) decreasing in extinction risk by two categories. Only one change in threat status represents a genuine change; all other changes are non-genuine changes 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. We will discuss which species represent high priorities for further ecological research and where urgent conservation actions are needed.