The island does not have deep water docking, requiring the use of tenders for cruise ship passengers to disembark and embark.

Published by The Louisville Journal, the letter described gale force winds, and "rain [that] poured in torrents" as they passed the area of the island.

[4] On June 22, 1901, the British sloop Lizzie Culmer was blown ashore the island and wrecked, resulting in the death of one woman.

Britton, the director of the New York Botanical Garden, led a party to the island in hopes of finding new plant specimens.

[9] In 1935, for his annual fishing trip, President Franklin D. Roosevelt, with the USS Farragut as an escort, sailed John Jacob Astor IV's former yacht Nourmahal around the Bahamas.

While off the coast of Little San Salvador, the party set off in small boats on an excursion to capture tropical fish to be added to tanks aboard the Nourmahal.

[10][11] While on a Good Neighbor policy trip to the Bahamas in March 1936, Roosevelt returned to the island aboard the Presidential yacht USS Potomac for recreational swimming and fishing.

[22] Knut Kloster, founder of Norwegian Cruise Line, began negotiating to buy Little San Salvador in 1979, to guarantee his ships could always dock, "for an afternoon of swimming and lazing on the beach.

North Arrival Plaza with a new pier to allow some of Carnival's ships to dock was announced, removing some of the need to tender to the island.

The new pier is intended to handle ship up to the Excellence Class size, including the Mardi Gras launched in 2020.

[32] Activities offered on the island include swimming, sunbathing, scuba diving, jet-skiing, cycling, and snorkeling.

A variety of water toys are available for rent, including Hobie catamarans, Sunfish sailboats, windsurfing sailboards, and kayaks.