Urban floods have become a critical development challenge for both developed and developing countries. They are particularly problematic in Africa, the world’s fastest urbanizing region. This paper explores the impacts on and readiness of African cities in dealing with urban flooding using Accra, the capital of Ghana - a West African country - as a case study. Accra is a rapidly growing coastal city affected by perennial flood hazards, and with rising sea levels, flooding may become an even greater problem. Flood events have been attributed to overflow of rivers within the city’s catchment, uncontrolled growth, poor waste disposal and rapid urbanization. Climate variability and/or change have also been cited as a cause of urban flooding. Using documentary review and institutional data, the study presents key issues in urban flood risk management and suggests the way forward for planning urban resilience to flood events.