The Vietnamese Mekong Delta (VMD) has an interlaced river system including both natural rivers and manmade canals connecting to the sea. The VMD is quite flat and has an extremely low mean elevation of about 0.8 m above sea level. It is also one of the most vulnerable deltas in the world to climate change and sea level rise. The VMD is a key food, agricultural and fishery production area of the country and is home to more than 17 million people (accounting for nearly 18 percent of the country's population). The VMD suffers from land subsidence every year due to groundwater over-exploitation together with a lack of landbuilding alluvium as a result of the construction of hydroelectric dams in upstream countries. The lack of freshwater from upstream, coupled with rising sea levels, have also led to serious adverse impacts from saline intrusion in recent years. This paper discusses the main causes of these threats, and strategies for planning infrastructure to mitigate the impacts of salinity intrusion and sea level rise in the VMD.