Public administrations around the world are struggling to adapt urban spaces to the adverse effects of climate change since the disastrous potential in these places is evident with the tendency for approximately 50% of the world’s population to occupy urban districts. In this sense, it is important to mention the representativeness of extreme hydrological events around the world, whose increase of 1.5 °C, predicted in recent global climate reports, is capable of intensifying the frequency of heavier precipitation. In counterpoint to these challenges, natural solutions to combat climate change named nature-based solutions (NBSs) take into account biodiversity, human well-being, and the complexities of this interaction to protect, manage, and reduce risks of catastrophic consequences, often treated from multiple and conflicting perspectives. For this reason, this chapter aims, in light of the multicriteria decision-making approach, to promote important discussions and share new insights to support strategic decision-making from conception to implementation of NBS. From a critical analysis of the state of the art in this field, emerging topics in the area are addressed, with the potential to benefit researchers, students, the industrial sector, and professionals specialized in their decisions, with views to promote sustainable cities adapted to a world in a changing climate.