Abstract. The global population is increasingly concentrated in cities. Cities and urban areas face many challenges – economic, social, health and environmental – which are often exacerbated by an increase in the frequency of natural disasters. Together, these challenges call for a shift towards sustainable cities which reduce their impact on the surrounding environment, whilst at the same time succeeding to make resources available to their increasing number of inhabitants. This study explores the state of the art of water management practices of the highly urbanised Northern Italian region and plans and scope for the future development of water management. Although the region is at present not under severe water stress, recently some cities faced water scarcity problems and were forced to implement water rationing. We assessed the vulnerability of Parma and Ferrara to a water crisis, together with the regular and emergency adaptation measures already in place, and the forecast for the near future. In two workshops, the authors adapted the Australian concept of water sensitive urban design for the Italian context. Although the population remains generally unaware of the impact of the two latest severe drought events (2003 and 2006/7), many adaptation measures towards a more sustainable use of the water resource are already in place – technically, institutionally, and individually. Water managers consider however that the drastic and definite changes needed to integrate the urban water management cycle, and which minimise the ecological footprint of urban spaces, lay far in the future.