The paper addresses the present seismotectonic settings of Sakhalin Island resulting from the activation of the seismic process that started here with the Neftegorsk 1995 earthquake and continued with the Uglegorsk (III) earthquake in 2000. The high seismic potential of the island is shown to have been indicated by various seismotectonic data, including those obtained by extraregional and paleoseismogeological methods. The former indicates that M > 6.5 earthquakes could have been predicted a few years ago in the Sakhalin Island, including the Uglegorsk (III), 2000 earthquake area. Recent paleoseismogeological data also indicate that earthquakes with magnitudes of up to M = 7.5 can occur in various parts of Sakhalin Island. Possible earthquake occurrence areas independently constrained by different methods mostly coincide.