This chapter examines the dynamics of urbanization, exposure to hydro-meteorological risks, and ongoing environmental degradation in the Vietnamese Mekong Delta. We highlight the inherent vulnerability of the regions and propose strategic research directions for resilient urban development. Urbanization trends in the regions reflect major changes in demographics and urban infrastructure, while at the same time, the delta is dealing with escalating and often compounding climate risks. A detailed analysis of provincial-level action plans reveals key growth challenges, which necessitate robust adaptation strategies. To tackle these challenges, the chapter advocates a move towards more resilient urban planning and management. We suggest future action-oriented research directions that focus on reducing risks through improved urban management and the integration of green infrastructure. The chapter emphasizes the critical need for strategic actions that not only tackle immediate vulnerabilities but also advance long-term urban sustainability and resilience in response to climate change.