This study examines residents’ perceptions of sustainable tourism and regional development in Great Rye Island, Slovakia, which is particularly well-suited for cross-border urban and rural tourism. The area’s development falls short of its potential, and we examined the reasons for this from the perspective of the attitudes of local residents. Drawing on social exchange theory, the research explores how local identity, satisfaction with services and infrastructure, and expectations for development shape attitudes toward sustainable tourism. A survey of 528 residents was conducted between January and March 2025. Participation in the research was voluntary and anonymous, and the respondents were selected randomly. Data were analyzed using IBM SPSS, and the following analytical techniques were applied: descriptive statistics, ANOVA, principal component analysis (PCA) and k-means cluster analysis. The research revealed moderate satisfaction with local conditions and that residents prioritize social, cultural, and educational development over commercial or tourism-related services. Besides, development initiatives are likely to gain stronger legitimacy and community support when they build on settlement or Great Rye Island identities rather than on more distant regional or national frames. Furthermore, the analysis identified five underlying factors and eight resident groups with distinct profiles. Results show that dissatisfaction with basic infrastructure-especially utilities, roads, and cleanliness-emerges as a common concern and a prerequisite for tourism development. Moreover, identity alone does not determine support for tourism; rather, attitudes are shaped by the interplay of satisfaction, expectations, and local identities. The findings highlight the heterogeneity of borderland communities and underline the need for tailored development strategies that combine infrastructural improvements with initiatives enhancing community cohesion, cultural vitality, and environmental quality.