In the Caribbean, gun violence has reached crisis levels and regional heads of government have called for a public health approach to inform prevention and control. We describe the work of a multisectoral group convened to develop a “Pathway to Policy” to inform the regional approach. We utilized a systems mapping technique to inform our understanding of firearm-related crimes and injuries based on the expertise of stakeholders. The analysis is informed by publicly available data from thirteen countries of the Caribbean Community. Feedback loops showed that firearm-related crimes increased the chances of household poverty, national economic costs, deaths and disability and promoted a culture of violence, all of which reinforced gun violence. Interventions to reduce illicit access and use of firearms, social development programs, and investment in educational systems may balance rates of gun violence. We call for greater attention to the equilibrium between crime response strategies and prevention approaches.