re: Best Caribbean vacation spot for 10yr anniversary

St. John.

And I've been to Hawaii, Cabo, Cancun, Cozumel, and Jamaica.

Why St. John- you land in St. Thomas and its a ferry ride away. You can see islands all around you. The view is spectacular. You can take another boat ride and visit the British Virgin islands(must have passport). We did an island hop for a day and visited and snorkled around Cooper Island, Virgin Gorda(the Baths are a must!), and my husband dove the shipwreck that is in the movie The Deep.

I was lucky to stay in a 6 bedroom villa in Peter Bay. The house is named Coco de Mer.

-- Most of the responses you are going to get are just going to be the only one they've been to. --

My recommendations are going to have a diver's slant to them.
So, I don't know that I'll be the best person to give advice to you.
But, I do hope you have a great trip!
Congrats on the Anniversary.

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If you are set on the Caribbean, it does matter when you plan to go. Each island has its own festivals and celebrations. So, giving us a planning window would help.

Depending on what you want....
Here's a great reference for you to help yourself... LINK

Are you looking for a modern US city which happens to have an awesome beach and ocean views?
Do you want it to be more secluded and romatic?
Do you want it to be exclusive or out of the way?

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Belize doesn't have the greatest beaches and is pretty undeveloped still. The offshore reef also allows for sea grass which can freak some people out with regards to swimming right off the beach.

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Belize has some of (if not the best) diving in the world. If you are a diver and plan on doing dives on your trip, Belize is hard to beat. As a diver, I loved it.
The people all speak English and are super-friendly towards tourists. The food is great. The views are out of a post-card. Plus, it's only a 2.5 hour trip from Houston/Atlanta with a direct flight from Belize City to Ambergis Caye.

However, if you are not a diver.... TJRibMe is correct. It is still under-developed.
They have some cool activities like jungle tours, ruins, cave-tubing, zip-lining, and deep-sea fishing... but if laying around on the beach is your thing, you can do better elsewhere.