Vegetation existence contributes to environmental quality in urban areas. The increase in population and development of cities has led to land conversion with lesser vegetated areas. Information on land cover change is needed, especially for urban regional planning with green open space consideration. The research aims to analyze urban vegetation cover and its changes in two sub-districts of Medan between the years 1999 and 2019. Normalized difference vegetation index (NDVI) and change analysis were conducted in the research. The diversity of plants within these areas was observed. The results showed changes in vegetation cover areas in the mentioned years. In 1999, most areas were under a highly dense vegetation class, while in 2019, they were under a lowdensity vegetation class. This finding indicates a decrease in vegetation cover as a result of increasing built-up areas. Within the vegetation cover, it was found many tree species and agricultural plants. Those vegetations existed in some areas: city parks, house yards, gardens, agricultural fields, etc. A special emphasis should be placed on riverside areas with less vegetation in order to provide a higher level of protection, particularly in the event of a flood. To increase the vegetated areas and maintain the environmental quality, optimizing the land by replanting in the area with no or less vegetation should be done.