Inequalities in exposure to environmental health risks in homes, workplaces and the wider city are well understood, even if often poorly documented in low- and most middle-income nations. This is also the case for inequalities in health outcomes – for instance inequalities in years of life lost/premature death rates (especially for infants, children and mothers). There are also many inequalities in housing and living conditions, working conditions and access to services (that fall within the economic, social and environmental determinants of health). These inequalities (and the inequity that underlies them) can be seen between nations, within nations and very often within urban centres. Then there are inequalities in the draw of individuals or households make on finite resources and waste sinks through their consumption patterns and lifestyles – the most dramatic being the vast inequalities in individuals’ contribution to greenhouse gas emissions through which we are currently heading for dangerous climate change. There are also inequalities between nations, within nations and within localities in the capacity to build resilience to disasters and to the direct and indirect impacts of climate change. However, there are some cities where a range of inequalities have been addressed, often by addressing underlying causes. This chapter will present some of these and consider what they can teach us about addressing inequalities in environmental risks.