With an ever-growing population of around 10 million inhabitants (officially 7.9 in 2013), Ho Chi Minh City (HCMC) is set to become one of the largest cities in South East Asia and already occupies a major economic role in the area. To accommodate the increasing population, the megacity now stretches out in an urban continuum covering more than 800 square kilometers and is currently growing at a rate of 3.2% per year. If the neighboring provinces around HCMC are included, the total population reaches nearly 18 million people.This paper attempts to describe the interplay between HCMC and flood-related risks and offer some guidelines to deal with inundations. The potential risks of flooding by rain, tsunami and/or dam failure upstream of the city are evaluated and contextualized within the perspective of climate and human-induced environmental changes. The region is highly vulnerable to the combined effects of subsidence and rising sea levels and has already led to serious flooding that may extend spatially before the end of the century. We propose possible preventative solutions to urban flooding using a multi-pronged approach to issues regarding urban development and suggest a redevelopment strategy for major infrastructure projects.