This chapter explores how rapid urbanization and climate change threaten urban water security, using Windhoek, Namibia, as a case study. It highlights how adaptive, innovative approaches—such as resource-efficient systems and resilient storage—can transform hydrosocial systems to ensure sustainable water access, supporting healthier, more resilient cities (SDG 11) and safeguarding public health (SDG 3). The Windhoek experience underscores the importance of rethinking development pathways to build adaptive, equitable urban water systems in a changing world.