With the breakthrough of large models, Segment Anything Model (SAM) and its extensions have been attempted to apply in diverse tasks of computer vision. Underwater salient instance segmentation is a foundational and vital step for various underwater vision tasks, which often suffer from low segmentation accuracy due to the complex underwater circumstances and the adaptive ability of models. Moreover, the lack of large-scale datasets with pixel-level salient instance annotations has impeded the development of machine learning techniques in this field. To address these issues, we construct the first large-scale underwater salient instance segmentation dataset (USIS10K), which contains 10,632 underwater images with pixel-level annotations in 7 categories from various underwater scenes. Then, we propose an Underwater Salient Instance Segmentation architecture based on Segment Anything Model (USIS-SAM) specifically for the underwater domain. We devise an Underwater Adaptive Visual Transformer (UA-ViT) encoder to incorporate underwater domain visual prompts into the segmentation network. We further design an out-of-the-box underwater Salient Feature Prompter Generator (SFPG) to automatically generate salient prompters instead of explicitly providing foreground points or boxes as prompts in SAM. Comprehensive experimental results show that our USIS-SAM method can achieve superior performance on USIS10K datasets compared to the state-of-the-art methods. Datasets and codes are released on https://github.com/LiamLian0727/USIS10K.