With the military's departure, the decades-long practice bombing of Vieques stopped, and the island has become one of the more exclusive tourist destinations in the Caribbean.
But the cleanup of the bombing range on an island the Navy once called its "crown jewel" of live-fire training is expected to take another decade, and the mayor of Vieques noted the island of roughly 10,000 people still has no hospital to treat illnesses ranging from cancer to asthma that local residents blame on military activity.
Mayor Victor Emeric said Vieques is battling an unemployment rate of nearly 20 percent and depends on a crippled ferry system that serves as the primary link to the main island of Puerto Rico.
"Time passed and everyone forgot about us," said Emeric, who was born and raised in Vieques. "None of the development that we expected has occurred."
George Withers, a senior fellow with the non-governmental Washington Office on Latin America, recently published a report calling on the U.S. to respond more aggressively to the cleanup and other problems in Vieques. He said the lack of care for ongoing health problems remain big concerns.
"The overall impact on the quality of life for the people of Vieques has not really improved in the 10 years since the Navy left," he said.
The island was once a cause celebre, with people such as singer Ricky Martin, actor Edward James Olmos and politician Jesse Jackson joining hundreds of other protesters to demand that the Navy leave Vieques after an errant 500-pound bomb killed a security guard in April 1999.
But after the Navy left on May 1, 2003, interest in helping boost the island's economy waned, said Emeric, blaming both the U.S. and local government.
Even the domain of the island's official government website, which translates to "Vieques Revival," is up for sale. Emeric said many local residents are still trying to find their economic footing as they seek to develop land formerly under naval control.
He dismissed criticism that American investors are the only ones reaping economic benefits, saying, "Many North Americans are here because the Viequenses themselves sold them the land."
Of the 23,000 acres (9,300 hectares) that the Navy began to use for target practice in the early 1940s, 4,000 acres (1,619 hectares) have been awarded to Vieques municipality, 3,100 acres (1,255 hectares) went to the U.S. Department of the Interior and about 800 acres (324 hectares) to the Puerto Rico Conservation Trust.
The Navy has so far cleaned 2,540 acres (1,028 hectares), with the operation expected to run through at least 2025 in one of the Navy's most extensive rehabilitation efforts, budgeted at some $350 million.
"The Navy considers Vieques to be its highest priority in the munitions cleanup program," said Dan Waddill, who is managing the process. "Vieques gets by far the most effort and the highest amount of funding."
Waddill oversees 55 employees who work Monday through Friday cleaning 15,000 acres (6,070 hectares) of the former bombing range, mostly in the island's east. He noted that two-thirds of the workers are from Vieques.
He suggested it will be impossible to find all of the abandoned munition parts.
"We don't expect to leave anything behind that people might come into contact with, but there are layers of safety that prevent that kind of contact just in case something happens to be missed," said Waddill. "When you're covering a large area ... that's just life. Sometimes you don't find everything."
In late March, the U.S. Agency for Toxic Substances and Disease Registry issued a long-awaited report stating it found no proof that residents had been sickened by substances left behind by bombs and other munitions, identified by the Environmental Protection Agency as TNT, napalm, depleted uranium, mercury and lead. The report was rejected by thousands of Vieques residents, many of whom filed a lawsuit, later dismissed, that accused the U.S. government of causing illnesses by leaving harmful residues on the land.
Withers noted in his report that the Navy fired more than 300,000 munitions in Vieques from the mid-1940s to 2003, taking control of 77 percent of the land.
So far, the Navy has removed 17 million pounds of scrap metal and destroyed more than 38,000 munition items on land, according to Navy spokesman Jim Brantley.
The next step is to clear munitions underwater. Navy officials are mapping the area to determine where munitions are located, a process that will take up to 18 months, Waddill said.
"We expected that to take longer than the land cleanup," he said, adding that officials have to protect endangered coral species. "It takes time to do this kind of work safely."
Puerto Rico's Secretary of Government Ingrid Vila said the U.S. territory will push to ensure the remaining land be cleaned and returned to Vieques municipality.
Vila said officials also want to revive a 2003-2004 plan aimed at boosting the island's economy, including reopening a Vieques government office charged with economic development.
Tourism remains the island's main economic engine, with hotel occupancy growing from 41 percent to 56 percent in the past two fiscal years, according to Puerto Rico's tourism company. The number has dropped slightly so far this fiscal year.
Vila noted that a middle school is to open in Vieques in coming weeks, and that Puerto Rico's health secretary is meeting with officials in Vieques to discuss community needs.
"Vieques has to be a priority," Vila said as she met with community leaders celebrating the Navy's departure. "It cannot become relevant only when there's an anniversary."