While not all projected climate change impacts are affecting especially and directly at all the cities of the Baltic Sea region (bsr), including its basin, those cities expect very different direct as well as indirect impacts of climate change. The impacts are also a matter of location, if the city with its built structures and concentration of population is located in the northern or southern part of this basin, or more inland or directly at the coast. As there are many different definitions in use trying to determine what a city is, also in the different national contexts of the bsr, here it is cities in the sense of being human-dominated densely populated areas, which are also characterized by higher concentrations of built-up areas, infrastructure, and soil-sealing as well as socioeconomic roles than rural settlements are. Those characteristics render cities also especially vulnerable to climate change impacts while there are some opportunities arising too. There are many studies on climate change impacts on the Baltic Sea itself as well as on the various ecosystems, but the studies on the observed as well as potential future impacts of climate change on cities are disperse, many are also of a national character or concentrating on a small number of cases, leaving some cities not well studied at all. This renders an all-encompassing picture on the cities within the bsr difficult and even more complicated as every city provides a mix of built-up and open structures, of socioeconomic structure and role in a region, nation-state, or even on an international level, and further characteristics. Their urban development is dependent on manifold various interdependencies as well as climatic and nonclimatic drivers, such as, to name just a few diverse examples, urban to international governance processes, or topography and location, or also different socioeconomic vulnerabilities within the Baltic Sea basin. Accordingly every urban society and structure provides specific exposure, vulnerabilities, and adaptive capacity. Generally, the cities of the bsr have to deal with the impacts of temperature rise, natural hazards, and extreme events, and, depending on location and topography, with sea-level rise. With reference to temperature rise and the increase of heat waves, it is important to consider that cities of a certain size within the Baltic Sea basin contribute to their own urban climatic conditions and provide already urban heat islands. Also, urban planning and building facilitated by local political decisions contribute to the extent of urban floods as well as their damage, as these are regulating, for example, the sealing of soils or new built-up areas in flood-prone zones.