The current rapid, often unplanned urbanisation across Asia has wide-ranging economic, environmental, health, and social impacts. In an attempt to document the implications of this demographic transition, the Journal of Cities & Health in collaboration with the International Society for Urban Health (ISUH) launched a special issue. This special issue is composed of seven original research papers and one commentary that present a fair geographical coverage of urban Asia. This scholarship aims to: 1) enhance the state-of-the-art understanding of health risks, social vulnerability and adaptation policies in cities across Asia; 2) present case studies where local contexts were taken into consideration to respond to local health needs and cultural preferences; 3) highlight new evidence of health risks and the impact of the built environment; and 4) examine the use of emerging digital technologies and big data across diverse sectors for a more sustainable urban living environment. In the current context of COVID-19, new challenges, insights, and opportunities for change have arisen. Specifically, some crowded Asian cities offer successful approaches in battling early outbreaks of COVID-19 and provide a model for keeping the pandemic at bay, even if they can’t completely eliminate infections. Asian cities can make changes to design spatially distanced transport and recreation opportunities and the long-term implications for both infectious and chronic diseases. This editorial challenges urban policymakers to better align city planning processes with societal goals and public values, for sustainability, health and health equity, and to hold the people of the city as the central plank in all planning processes.