The Category 5 storm -- which could be the island's most violent on record -- is charting a painstakingly slow path through the Caribbean, and has already been blamed for three deaths in Jamaica, three deaths in Haiti and one in the Dominican Republic.
The US National Hurricane Center (NHC) reported that Melissa was still 150 miles (240 kilometers) from Kingston late Monday, and reaching maximum wind speeds of 175 miles per hour.
Its heavy rains combined with intense winds could wreak devastation on par with historic hurricanes, including 2017's Maria or 2005's Katrina, which left indelible impacts on Puerto Rico and the US city of New Orleans.
Scientists say human-driven climate change is causing such massive storms to become increasingly common in the region.
Local government minister Desmond McKenzie said Monday evening that of the island's 880-odd shelters standing by, only 133 were hosting locals.
They "should be seeing people now", McKenzie said, adding: "I want to urge persons in these parishes to get to high ground as quickly as possible."
Jamaican Prime Minister Andrew Holness said the island's western end faced the worst destruction.
"I don't believe there is any infrastructure within this region that could withstand a Category 5 storm, so there could be significant dislocation," he told CNN.
But despite pleas to evacuate, many Jamaican residents were staying put.
"I am not moving. I don't believe I can run from death," Roy Brown told AFP in Kingston's seaside area of Port Royal.
The plumber and tiler said he was reluctant to flee because of his past experiences with the poor conditions of government hurricane shelters.
Fisherwoman Jennifer Ramdial agreed, adding: "I just don't want to leave."
Holness told a press briefing that the evacuation was about "the national good of saving lives."
"You have been warned. It's now up to you to use that information to make the right decision," he said.
- 'Catastrophic' -
Part of Melissa's punch stems from its slow pace: it is lumbering along slower than most people walk, at just three miles per hour or less.
That means areas in its path could endure punishing conditions for far longer than during most hurricanes.
The NHC warned of "catastrophic" flash flooding, landslides and destructive winds that could cause lengthy power and communications outages, along with "extensive infrastructural damage."
Up to 40 inches (one meter) of rainfall are forecast, with flash flooding and landslides expected in Jamaica as well as Haiti, the Dominican Republic and Cuba.
A storm surge is likely along Jamaica's southern coast, with waters potentially rising 13 feet (4 meters), along with "destructive waves."
In the Flagaman farming community of St. Elizabeth, residents hunkered down in a store.
Owner Enrico Coke said he opened his place for fear that his neighbors had nowhere to go: "I'm concerned about farmers, the fishermen will be suffering after this."
"We'll need help as soon as possible, especially water for the people."
- Dangerous flooding -
After pummeling Jamaica, Melissa is forecast to cross over eastern Cuba on Tuesday night.
The storm has already left tragic consequences.
On Monday, officials in Jamaica said three people had died while preparing for the storm, cutting tree branches and working on ladders.
In the Dominican Republic, a 79-year-old man was found dead after being swept away in a stream, officials said. A 13-year-old boy was missing.
Haiti's civil protection agency said three people died in storm conditions over the weekend.
Meteorologist Kerry Emanuel said global warming was causing more storms to rapidly intensify as Melissa did, raising the potential for enormous rains.
"Water kills a lot more people than wind," he told AFP.
The last major hurricane to impact Jamaica was Beryl in July 2024 -- an abnormally strong storm for the time of year.
"Human-caused climate change is making all of the worst aspects of Hurricane Melissa even worse," said climate scientist Daniel Gilford.
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