This text presents an analysis of Caribbean fiscal problems, with particular emphasis on the relationship between high levels of public expenditure and balance of payments problems. The study examines deficit financing, public expenditure growth, and IMF stabilisation policies. Other issues raised relate to income distribution and problems of taxation and tax reform. The work focuses on Jamaica, Guyana, Barbados and Trinidad and Tobago. The economies of the Organisation of Eastern Caribbean States are also considered. This work should interest scholars in economics and economic policy-making, especially those in developing countries.