Climate change and unplanned urban growth remain two emerging environmental and health threats with widespread implications for poor countries. Yet, despite attempts by governments and international organisations at addressing these challenges, they remain unabated. Understanding the challenges through a resilience lens can support actions for addressing these impacts. Regardless of this potential, the application of urban resilience to sustainable urban environments remains a distant reality in areas most vulnerable to the impacts of these environmental and health threats. Understanding of the application of the resilience concept to urban development and its outcomes are limited in Ghana. This study fills this gap by focusing on: the extent of climate change in the city of Kumasi; local experiences of major unplanned urban growth challenges in Kumasi; local understanding of urban resilience; and efforts towards urban resilience. Using institutional interviews and household surveys, findings indicate a rising trend of temperature and unpredictable rainfall pattern in Kumasi. This situation is generating negative consequences such as flooding, destruction of ecologically sensitive areas, and related diseases such as malaria. Complicating matters further are the impacts of unplanned urban growth, including poor sanitation conditions, inadequate social services, and poor housing conditions. Unfortunately, despite these challenges, there is limited understanding of urban resilience in Kumasi, amongst both urban planning related institutions and local communities. As a consequence, institutional initiatives towards urban resilience are uncoordinated and incomprehensive.