This chapter addresses the role of urban design in the face of climate change impacts on cities. It mainly focuses on paradigms and directions essential for us to reverse some of our erroneous planning and development trends in the last few decades or provide us with innovative directions of change and transition. This is conducted through extensive literature review and based on available discourse on the role of sustainable urban design in the face of climate change. Here, we opt to oppose high-rise residential development as a common trend in practice. Thus, this chapter questions ‘how can we implement sustainable development at the urban design scale?’ detailed enough to achieve tangible impacts at the micro and meso scales of the built environment. Through this, we provide a set of analytical viewpoints on 12 fundamental principles that include: (1) Density; (2) Energy efficiency; (3) Building services; (4) Urban microclimate; (5) Solar/Heat; (6) Embodied energy; (7) Operational energy; (8) Embodied maintenance; (9) Ventilation; (10) Materials transportation and construction; (11) Post-use; and (12) Design. We intentionally put design at the end to ensure addressing all other principles before reaching the actual design aspect. To do so, we provide an analytical approach to each of these principles, feeding into a set of paradigms and directions for achieving sustainable urban design. These principles, some technical, enable planners and policymakers to reconsider the business-as-usuals (BAUs) and rather seek innovative models of development. By entering the age of ‘climate change impacts’ already, it is essential to address these at the planning and design levels and not any later stage.