This chapter addresses causative factors and institutional response capacity to cope with the impacts of climate change in Dar es Salaam. Rapid population growth in the city has increased both environmental and socio-economic pressures, and has led to a worsening of settlement systems and patterns. Meanwhile, haphazard urban development has led to land degradation due to stone and sand mining, air and water pollution from untreated domestic and industrial waste, land and scenery pollution due to solid waste, the disappearance of green belts, and the loss of biodiversity. Recurrences of drought conditions and increased rainfall intensity have had significant social and environmental impacts, resulting in power and food shortages, losses of livestock and agricultural crops, and flood-related damages to infrastructure, human settlements, and livelihoods. Such conditions often correspond to the spread of diseases like malaria, diarrhea, and cholera, which have economic impacts for the government and families. Moreover, coastal erosion, loss of coastal and marine ecosystems, saline intrusion in freshwater bodies, inundation of low-lying coastal areas, and reduced freshwater flows due to sea level rise are evident. A number of adaptation strategies are in place that entail community involvement in planning processes.