Currently, heritage is challenged in the Indian city of Surat due to diverse pressures, including rapid urbanization, increasing housing demand, and socio-cultural and climate changes. Where rapid demographic growth of urban areas is happening, heritage is disappearing at an alarming rate. Despite some efforts from the local government, urban cultural heritage is being neglected and historic buildings keep being replaced by ordinary concrete buildings at a worryingly rapid pace. Discussions of challenges and issues of Surat’s urban area is supported by a qualitative dataset, including in-depth semi-structured interviews and focus groups with local policy makers, planners, and heritage experts, triangulated by observation and a photo-survey of two historic areas. Findings from this study reveal a myriad of challenges such as: inadequacy of urban conservation management policies and processes focused on heritage, absence of skills, training, and resources amongst decision makers and persistent conflict and competition between heritage conservation needs and developers’ interests. Furthermore, the values and significance of Surat’s tangible and intangible heritage is not fully recognized by its citizens and heritage stakeholders. A crucial opportunity exists for Surat to maximize the potential of heritage and reinforce urban identity for its present and future generations. Surat’s context is representative of general trends and conservation challenges and therefore recommendations developed in this study hold the potential to offer interesting insights to the wider planners and conservationists’ international community. This paper recommends thoughtful integration of sustainable heritage urban conservation into local urban development frameworks and the establishment of approaches that recognize the plurality of heritage values.