Can Tho City, located in Vietnam’s Mekong River Delta (MRD), is one of the biggest and fastest-developing cities in southern Vietnam. Water management in the city is a complex undertaking that faces a number of constraints: increasing urbanization, rapid population growth, inadequate infrastructure development, and inefficiencies in management. Combined with these, an increase in demand for domestic water, water pollution, seasonal inundation, and the scarcity of clean water pose huge water management challenges for the city. These issues have added a layer of uncertainty in terms of both temporal scale and change magnitudes from climate change and rising sea levels. To address these challenges, the city requires not only appropriate short-term adaptation measures, but also policies and strategies for long-term urban water management. This chapter presents findings from a year-long study that aimed to: identify key stakeholders and tools to support the decision-making process for urban water management; build a complete multi-agent model to evaluate present and future scenarios; and engage with stakeholders to ensure the developed model’s results are taken up and used in future decisions. The study uses system dynamics i.e. methodologies to frame, understand, and discuss complex issues and problems. Through a multi-agent modeling exercise, which was built on a combination of the Storm Water Management Model (SWMM) (flood simulation model) and VENSIM (water quality simulation model), a number of short-term and long-term policies and strategies were produced to address water insecurity in Can Tho City.