Can Tho city is located in the Mekong Delta, about 170km southwest of Ho Chi Minh City, Vietnam. During the last two decades, the economic growth and urbanization of the region have increased at a very high rate and there has been significant development of residential, commercial, and industrial areas. The rapid growth rate of Can Tho city and the region has put great pressure on environmental conditions within the city. Because of the lack of sustainable development and environmental quality considerations associated with significant population increase, Can Tho?s urban environment has been facing with many pollution problems in the various aspects of air, noise, water pollution, wastewater, solid waste, and environmental related diseases. In addition to meeting the basic requirements of sustainable urban development, the city, as located in a low-lying delta, must now consciously adapt to changing climates through planning and designing climate-adapted built environments. This paper provides a summary of the case study of urban water systems in Can Tho city Vietnam of the Climate Adaptation through Sustainable Urban Development project, supported by the Research for Development Alliance (RfD Alliance) between CSIRO and Agency of International Development (AusAID) of Australia. The project was a collaboration between CTU and CSIRO, undertaken over two years from October 2010 to November 2012. The project had three focus areas, which were: (1) understanding the current context of urban water, including the implications of future socio-economic development and climate change; (2) developing strategic adaptation plans for the city?s water systems; and (3) demonstrating a range of adaptation options through pilot case studies. The research was underpinned by the development of strong partnerships with local governmental organisations, and also the active involvement of local research partners.