Two bridges allow access to the island from Victoria, on Pental Island Road at Swan Hill in the west, and on Fish Point Road at Fish Point in the east. There are no crossings to the island over the Murray from New South Wales.
Pental Island is one of two areas (the other is Beveridge Island) which were the subject of border disputes between the states of Victoria and New South Wales. When the Murray was opened for navigation the question arose as to whether all navigable channels were part of New South Wales, as claimed by that state, or whether the Little Murray River was a continuation of the Loddon River enclosing Pental Island as claimed by Victoria. The dispute was raised in 1871 and was resolved in favour of Victoria by the Judicial Committee, with no detailed reason given.