This chapter stresses the importance of addressing urban issues within the framework of regional and global biophysical systems (climate change). Considering urban growth only as the outcome of local forces creates an incomplete perspective of complex realities. The chapter focuses on the vulnerability and adaptation of urban areas to the potential impacts of climate change in poor countries and emerging economies and explores a role of urban planning in building adaptation strategies. It also highlights the need of new multidimensional approaches orienting urban growth and the responses to climate change. Many of the actions needed to reduce social and urban vulnerability and enhance adaptation to climate change strongly relate to current development pressures in urban areas. Efforts in this direction can make a difference in the livelihood of millions of present and future urban inhabitants.