The coupled processes of climate change and urbanization pose challenges for water resource management in cities worldwide. Comparing the vulnerabilities of water systems in Phoenix, Arizona and Portland, Oregon, this paper examines (1) exposures to these stressors, (2) sensitivities to the associated impacts, and (3) adaptive capacities for responding to realized or anticipated impacts. Based on a case study and survey-based approach, common points of vulnerability include: rising exposures to drier, warmer summers, and suburban growth; increasing sensitivities based on demand hardening; and limited capacities due to institutional and pro-growth pressures. Yet each region also exhibits unique vulnerabilities. Comparatively, Portland shows: amplified exposures to seasonal climatic extremes, heightened sensitivity based on less diversified municipal water sources and policies that favor more trees and other irrigated vegetation, and diminished adaptive capacities because of limited attention to demand management and climate planning for water resources. Phoenix exhibits elevated exposure from rapid growth, heightened sensitivities due to high water demands and widespread increases in residential and commercial uses, and limited adaptive capacities due to weak land use planning and "smart growth" strategies. Unique points of vulnerability suggest pathways for adapting to urban-environmental change, whether through water management or land planning. Greater coordination between the land and water sectors would substantially reduce vulnerabilities in the study regions and beyond.