Increasing concerns regarding oil spills, air pollution, and climate change associated with fossil fuel use have increased the urgency of the search for renewable, clean sources of energy. This assessment describes the potential of Ocean Thermal Energy Conversion (OTEC) to produce not only clean energy but also potable water, refrigeration, and aquaculture products. Higher oil prices and recent technical advances have improved the economic and technical viability of OTEC, perhaps making this technology more attractive and feasible than in the past. Relatively high capital costs associated with OTEC may require the integration of energy, food, and water production security in small island developing states (SIDSs) to improve cost-effectiveness. Successful implementation of OTEC at scale will require the application of insights and analytical methods from economics, technology, materials engineering, marine ecology, and other disciplines as well as a subsidized demonstration plant to provide operational data at near-commercial scales.