This chapter explores how climate change, rising groundwater tables, and frequent flooding affect informal settlements in Cape Town. It examines the socio-economic and environmental vulnerabilities that make these areas particularly susceptible to groundwater-induced flooding, especially during winter rainfall. Drawing on qualitative fieldwork and secondary data, the chapter unpacks how rising groundwater levels destabilize housing structures, compromise sanitation, and increase health risks. It highlights community experiences and coping strategies, revealing that while some residents deploy transient and adaptive mechanisms, others remain trapped in flood-prone areas due to poverty and limited options. The chapter evaluates innovative solutions including AI- and IoT-enabled early warning systems, flood-resilient infrastructure, and sustainable construction materials. It also emphasizes community-based adaptation and participatory planning as key to enhancing resilience. Finally, it critiques current governance and policy frameworks, proposing multi-scalar, integrated approaches to flood risk management that prioritize equity, sustainability, and long-term climate adaptation in informal settlements.