Urbanisation in PICs is rapid. Urban planning and management capacity are limited. Economic and environmental pressures are mounting and eroding urban resilience and livelihoods. Because urban planning and regulatory frameworks are weak, national politics and elite interests strongly influence urban development, and inequities in cities are growing. No regional organisation has responsibility for urban issues, urban resilience frameworks are poorly defined, so fragmented and ineffective urban strategies persist, while national policies and practices are resolutely anti-urban. Concerted regional action could enable sharing of knowledge and successful strategies, coordinate urban action to build resilience, and enable a more proactive political and policy agendas for more sustainable and resilient cities.