Water-based urbanism, that is, the design of cities around the role and dynamics of water, has been a powerful urban impetus in many parts of the world. As a consequence of the location of cities along major rivers, on seacoasts, and in inland and coastal deltas, water urbanism is indeed a predominant part of the history and current status of many cities. However, water urbanism has changed and continues to face pressures to evolve. These pressures include a shift to urbanism based on transport by roads, and the need to adapt to changing climate and rising sea level. This chapter addresses changes in the paradigm of water-based urbanism, and summarizes opportunities to improve urban resilience by reclaiming key insights from the traditions of designing with water, as exemplified in Europe and South and East Asia.