Small Island Developing States (SIDS) are pressing sustainable development needs, yet entrepreneurship and innovation research in SIDs contexts is fractured and Western-centric. This article responds to such necessary research gaps by conducting a systematic literature review to identify conceptual, methodological, contextual, and intersectional gaps in the literature. Finding shows the need for a deeper understanding of entrepreneurial behavior. To address this, this article proposes an Entrepreneurial Social Innovation (ESI) Framework, consolidating insights from theories of Effectuation, Resilience, and multilevel approaches, to provide an integrated model incorporating informal, digital, and gender-sensitive practices tailored for SIDS, and focusing specifically on the Maldives. This framework develops theoretical knowledge of hybrid value creation in fragile contexts. It offers policymakers and practitioners a model to follow in order to foster context-relevant sustainable development in SIDS.