Megacities have frequently received a disproportionate amount of attention over other sizes of cities in recent discourse on urban sustainability. In this article, the authors argue that a focus on smaller and medium-sized cities is crucial to achieving substantial progress towards more sustainable urban development, not only because they are home to at least a quarter of the world’s population but because they also offer great potential for sustainable transformations. In principle, their size allows for flexibility in terms of urban expansion, adoption of “green” travel modes, and environmental protection. At the same time, smaller and medium-sized cities often have fewer resources to implement new transport measures and can be more vulnerable to fluctuations in the world economy. This article critically reviews the potential role and impact of nine commonly considered options for sustainable urban transport in cities in developing countries: (1) road infrastructure; (2) rail-based public transport; (3) road-based public transport; (4) support for non-motorized travel modes; (5) technological solutions; (6) awareness-raising campaigns; (7) pricing mechanisms; (8) vehicle access restrictions; and (9) control of land-uses. Drawing on international research and examples of policies to reduce the environmental impacts of transport in urban areas, this article identifies some key lessons for sustainable urban transport in smaller and medium-sized cities in developing countries. These lessons are certainly not always identical to those for megacities in the global south.