The need to elucidate the urbanization–climate–pollution nexus in West African arose from the several reported, but disjointed cases of climate extremes and environmental degradation in the sub-region. This review analyzed several scenarios, to appraise the trends and relationships among the individual elements in the nexus and to ascertain the status of sustainable development in the sub-region, using the expository review methods. Urbanization was essentially characterized by population growth without complementary infrastructural development, weak coping strategies against climate extremes, numerous economic challenges, and high risk of environmental pollution. Initiative for urban renewal, urban greening and smart city development was low, and preparedness against future impact of extreme climate events and climate change is uncertain. However, there is clear evidence that the concept of sustainable development is growing in the sub-region. This is intensified by the international funding agencies insisting on the incorporation of environmental issues into development, the enactment of environmental laws and policies, and the establishment of institutions of enforcement in each country. The review concluded that although the sub-region is at the brink of severe effects of population explosion and environmental degradation, the growing awareness and implementation of the sustainable development goals may come to the rescue.