A phylogenetic meta-analysis of patterns and drivers of body size evolution across a global sample of paired island-mainland populations of terrestrial vertebrates shows that 'island rule' effects are widespread in mammals, birds and reptiles, but less evident in amphibians, which mostly tend towards gigantism. Island faunas can be characterized by gigantism in small animals and dwarfism in large animals, but the extent to which this so-called 'island rule' provides a general explanation for evolutionary trajectories on islands remains contentious. Here we use a phylogenetic meta-analysis to assess patterns and drivers of body size evolution across a global sample of paired island-mainland populations of terrestrial vertebrates. We show that 'island rule' effects are widespread in mammals, birds and reptiles, but less evident in amphibians, which mostly tend towards gigantism. We also found that the magnitude of insular dwarfism and gigantism is mediated by climate as well as island size and isolation, with more pronounced effects in smaller, more remote islands for mammals and reptiles. We conclude that the island rule is pervasive across vertebrates, but that the implications for body size evolution are nuanced and depend on an array of context-dependent ecological pressures and environmental conditions.