Caribbean communities were mobile long before European colonization and their modes of production and culture were evolving by frequent exchanges among the Caribbean islanders and the Northern coast of South America. However, the region has not fully benefited by the advent of the five Technological Revolutions since 1771. Moreover, in the last two decades of the XX century, the Caribbean Small Islands Developing States (SIDS) were severely affected by the migration of their tertiary educated population towards the developed world, a trend that continues today. Bibliometric approaches have been used to identify not only the brain drain, but also how the contemporary knowledge is created through the international network of scientific collaboration. In this study we use the Scopus bibliographic database to analyse the scientific output and international collaboration of the 13 Caribbean SIDS in the period between 2000 and 2018. The main scientific collaborator of the region as a country is United States, except for Cuba, which is Spain. Consequently, North America, Europe and the Caribbean islands share the higher proportion of co-authoring articles. In terms of institutional representation, the University of West Indies has, in aggregate, the highest output with 11,497 documents from 11 out of 13 SIDS. The main contributor as a country is Jamaica (5018), followed by Trinidad and Tobago. A group of high output academic institutions are University of Havana (4979), followed by Universidad Central de Las Villas, Institute of Tropical Medicine Pedro Kouri and the Centre of Genetic Engineering and Biotechnology, all of them in Cuba and with no significant collaboration with the rest of the region. In previous bibliometric studies we found that the scientists working abroad has the potential to become agents for development of the home country and region, diversifying the scientific collaboration.