Small island states receive unprecedented amounts of the world’s plastic waste. In March 2019, we removed as much plastic litter as possible from Aldabra Atoll, a remote UNESCO World Heritage Site, and estimated the money and effort required to remove the remaining debris. We removed 25 tonnes at a cost of $224,537, which equates to around $10,000 per day of clean-up operations or $8,900 per tonne of litter. We estimate that 513 tonnes (95% CI 212–814) remains on Aldabra, the largest accumulation reported for any single island. We calculate that removing it will cost approximately $4.68 million and require 18,000 person-hours of labour. By weight, the composition is dominated by litter from the regional fishing industry (83%) and flip-flops from further afield (7%). Given the serious detrimental effects of plastic litter on marine ecosystems, we conclude that clean-up efforts are a vital management action for islands like Aldabra, despite the high financial cost and should be integrated alongside policies directed at ‘turning off the tap’. We recommend that international funding be made available for such efforts, especially considering the transboundary nature of both the marine plastic litter problem and the ecosystem services provided by biodiversity-rich islands.