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The paper deals with coastal aquifers exploitation under saline intrusion threats and climate change effects over them. For sustainable development of these resources variable but necessary policies are required, among them: selection of abstraction works and their appropriate design, knowledge of the aquifer system, control measures over variables for decision making, use of advanced technologies to define optimal exploitation strategies, efficient operation and maintenance of existing works. It is suggested, when feasible, to give preferential use to horizontal works but avoiding open trenches because of the inconveniences that have been observed in the Cayo Largo del Sur and Andros-Bahamas case studies. The use of vertical wells demands a careful design, not only of each well but also of their spatial distribution, therefore the paper includes some recomendations to this end. [ABSTRACT FROM AUTHOR]