The world’s present coastal land use is unsustainable in the face of sea level rise and storm surges induced by climate change. This is true of urban, suburban, and—to some degree—recreational use of coastal land, but it is especially true of the urban infrastructure that serves our economic activities and livelihoods. Hurricane Sandy was only one example of what the future holds; such events will occur with greater frequency and severity as the level of the ocean rises as much as 6 feet by the end of this century. Therefore, architects, engineers, designers, urban planners, developers, infrastructure operators, and decision makers in the private and public sectors must start planning now the best ways to minimize the increased flood hazards that threaten the built environment. Using New York City as a case study, this article delves into the major competing approaches: defending against flood and rising waters with massive earthworks and expensive engineered structures; accommodating to and living with the rising waters so that the city can recover quickly after flooding; strategically relocating to higher ground; and spreading the risk via insurance. It also examines two other options: doing nothing, and stopping the flooding problem at its source.