This paper explores physical, psychological, social, and institutional vulnerabilities associated with slow-onset events (SoEs) of climate change. Based on review of interdisciplinary research in the context of Pakistan, this paper reviews the relevance of multi-level vulnerabilities and how they exacerbate impacts of SoEs of climate change. The physical vulnerabilities of climate change have been relatively well researched; however, research on the psychological, social, and institutional vulnerabilities and their intersectional associations with SoEs have been rare. Therefore, this review highlights the need for understanding multi-level vulnerabilities of high-risk groups in Pakistan. This paper emphasizes the need to work with an integrated approach for vulnerabilities of marginalized subgroups such as gender (women’s marginalized status), socio-economic status (lower SES), displacement history, and migration background. Finally, we propose the need for inclusive policy building sensitive to the demands of vulnerable groups in Karachi and elsewhere in Pakistan. We hope that this multilevel and inclusive framework has the potential to guide practitioners, and especially those who are least prepared for the slow-onset events of climate change.