Unlike in North American countries, only a slight majority of European inhabitants live in cities and towns (58% according to our database) but 80% of urban settlements may be considered as small entities, i.e. between 10,000 and 50,000 inhabitants. This density of small urban areas in Europe is the result of a long-standing urban pattern that was established mainly in the late Middle Ages. Whereas European planning policies focus mainly on large urban functional areas, we assume that they should pay more attention to these small cities and towns, especially when these are facing challenging situations such as prominent population losses. Starting from a harmonized urban database defined by the European Environment Agency from CORINE Land Cover images (Urban Morphological Zones) and the 2001 Density Grid population (Joint Research Center), we first describe the large heterogeneity of European countries regarding their amount of small cities, varying from 63 to 90%. We then build a dictionary of correspondence with local administrative units (LAU2) to model the extension of urban perimeters in 1981 and 1991 and populate UMZ with the Historical Population Database from 1981 to 2011. The results show that small cities and towns are particularly concerned by a demographic decline, compared to the whole set of cities and towns, and that the subset characterized by population losses is confronted to a more intensive decline than medium and large cities. We then enrich our set of harmonized indicators in order to better contextualize the territorial and demographic situations of European small cities and towns. Using clustering methods, we construct a multi-scalar urban-rural typology that describes seven settlement contexts and a classification of age structure. Results show that small cities and towns are particularly vulnerable: they are over-represented in rural regions and/or in ageing profiles. If only 50 of them combine population loss, ageing and rural isolation, they are located in one-third of the European countries, and when considering the number of affected regions (NUTS 3), they represent not less than 10% of the French “départements”, 15% of the Hungarian “megyeks” and the major part of the Swedish “län”.