The chapter compares the current approaches to incorporating climate change adaptation considerations into growth management planning initiatives for the most rapidly urbanizing metropolitan regions in the People’s Republic of China and Australia-namely, the Yangtze delta region and the South East Queensland region, respectively. In contrasting these initiatives against contemporary practices and accepted principles for climate change adaptation at regional scale, the chapter considers how these growth management initiatives require their respective communities and institutions to address climate adaptation at regional and local spatial scales, within the context of the longer-term temporal scale that these strategic plans traditionally cover. In examining current strategic planning practices, the chapter has investigated how they are attempting to deal with the uncertainty of evolving climate change science and the extended time frames that strategic adaptation policies need to address. The chapter concludes with a comparison of the challenges, lessons, and potential adaptive pathways for the contrasting settings of Australian and Chinese cities drawn from the case studies.