Respiratory tract infections (RTI) present a significant public health concern and are overrepresented in urban environments. Urban design that includes both the built and natural environment (green and blue spaces) influences human encounters (density and mobility), and in this way, either directly or indirectly, the occurrence of respiratory infections. Important determinants possibly contributing to the risk of acquiring an RTI include, among other things, land use, types of buildings, services, industry, connectivity, as well as the number and types of open spaces. The way cities are planned can also alter how urban residents are exposed to air pollution and weather (temperature, humidity, wind), which can vary significantly between different neighborhoods. These exposures can further modify the risk of contracting an RTIs, but from which empirical evidence is largely lacking. Future epidemiological studies are needed to assess the interlinkages between fine-scale physical characteristics of urban environments, environmental exposures, and the occurrence of RTIs. This knowledge could be used to improve urban design and reduce the influence of future epidemics or pandemics in cities.