Despite its small population and land area, Bhutan is among the most rapidly urbanizing countries in South Asia. While this urbanization parallels robust economic growth and the expansion of job and investment opportunities in cities, there remain challenges to fully leveraging the potential of urban areas. Bhutan has made impressive gains toward the convergence of access to basic services across the country, but there are gaps in the quality of coverage, particularly for water and sanitation. Local governments will have an increased role in basic service provision and capital investment, but it requires enhanced capacity and resources to improve efficiency and responsiveness to local needs. Urban growth has increased demand for quality housing, which has resulted in a scarcity of affordable units and has increased pressure for urban expansion. Finally, the concentration of people and property in growing cities also changes the hazard risk profile of these areas, which is not adequately understood due to a lack of adequate data systems and poor integration into planning mechanisms. An integrated approach to urbanization is essential; one that leverages the benefits of agglomeration while also managing the diseconomies and negative externalities of urban growth.