Background: Egypt's major cities have been losing heritage and historical buildings due to neglect and misuse, prompting non-governmental organizations, academic institutions, and researchers to advocate for adaptive reuse strategies to preserve the cities' heritage and identity. Adaptive reuse involves changing, modifying, or reusing a space based on community needs, business model, location, and proximity to facilities and services. Heritage buildings offer many tangible and intangible benefits that enhance financial returns, making them challenging but feasible and attractive for investors who value authenticity, uniqueness, and sustainability. Methods: This study examines how market value, acquisition opportunities, target clients, age groups, and socioeconomic status affect decision-making. A comparative analysis of three buildings in the Egyptian cities of Alexandria and Cairo is utilized to establish development guidelines and decision-making parameters that significantly impact project design and building functions to determine the highest and best use. In order to complete this study, AutoCAD by Autodesk was used for 2D drawings, SketchUp by Trimble for 3D models, Adobe Photoshop for diagram presentation, and Microsoft Office for tables and diagrams. Results: The comparative analysis provided valuable insights into the adaptive reuse of heritage buildings in developing countries. Findings highlighted how cultural heritage preservation could foster socioeconomic development. Key success factors included stakeholder and community engagement, financial viability, and architectural compatibility. The decision-making framework provides a practical tool for evaluating heritage building reuse. Conclusions: The analysis illustrates successful reuse strategies and considerations. Decision-making frameworks and tools offer practical guidance for future investments and decisions. These findings affect heritage conservation and urban development policymakers, planners, and investors. Stakeholders can make informed decisions and implement strategies to preserve cultural and environmental value by realizing challenges and opportunities. This study hopes to inspire more research and help preserve and revitalize heritage buildings in developing countries, preserving their cultural and socioeconomic value.