Coastal low-lying sand islands confront an imminent threat owing to global warming, primarily stemming from the confluence of rising sea levels and amplified precipitation variability. These islands harbour delicate freshwater reservoirs in unconfined aquifers, reliant significantly upon precipitation for replenishment. This investigation focuses on a sand island situated along Australia’s eastern coast, resembling islands prevalent across the Indian and Pacific Oceans. The study involves comprehensive instrumentation to monitor Actual Evapotranspiration (AET) concurrently with rainfall patterns and water table fluctuations. Eddy Covariance (EC) systems were employed across three distinct vegetation zones: a wetland, a swamp, and a commercially managed pine forest plantation. The aim was to gauge evapotranspiration dynamics, comparing computed reference evapotranspiration (ET0) at each site with EC-measured values to establish novel reference vegetation coefficients (Kv) tailored to these specific environments. Actual evapotranspiration was found the largest at the wetland, the swamp, and the pine plantation in decreasing order. Pine plantation evapotranspiration was found the most sensitive to water table depth, while the native swamp and wetland maintained high evapotranspiration rates through dry periods. A simple idealized water balance is proposed for the island for the dry and wet seasons. Large rainfall events during the wet season were found critical in providing recharge of the aquifer, highlighting the importance of such events in maintaining the freshwater resource and vegetation health on such islands.