Purpose - This paper aims to present part of the research results in developing an adaptation process to cope with flood risk in coastal cities under the impact of climate change variability and rapid urbanization in Ho Chi Minh City, Vietnam. Design/methodology/approach - Two main assessment tools applied in this research are rapid vulnerability assessment and tool for environmental assessment and management. Findings - Under the same natural conditions, people living in more urbanized districts suffer with more inundation and risks from polluted floodwater than those who live in less urbanized districts. Notwithstanding, people in lower urbanized districts are more vulnerable since they have a low capacity to cope with flood and pollution due to flood-prone living conditions, poverty and lack of awareness on the changing variability and water pollution. Gender analysis in this research has found that men and women play different roles in coping with hazards, and women suffer with more risks than men especially in term of health, sexual harassment, and increasing responsibility. Practical implications - The adaptation process should focus on integrating vulnerability assessment findings appropriately with the assessment tools and gender analysis in order to develop as well as implement adaptation measures effectively and efficiently. This adaptation process should also be applied for other countries having different contexts of development under different levels of projected climate change-related risks. Originality/value - This research contributes in developing the process on adaptation to possible hazards related to climate change, especially for coastal communities of Vietnam and developing countries where the urbanization process is increasing rapidly.