Coastal cities will be significantly impacted in this century by climate change, including sea level rise, storm surge, inland flooding from intense precipitation events, and droughts. The need for adaptation measures is clear. The past 40 years have seen the development of extensive scientific interest in climate change impacts on coastal cities as well as important advances in the planning framework for adaptation to climate change. The tasks for the next 40 years are to begin and expand applied adaptation planning and to undertake the properly scheduled implementation of adaptations over time. If institutional and other challenges are overcome and resources are made available, it is probable that most US coastal cities can adapt reasonably well to the impacts of climate change, at least over the next 40 years.