Central America and the Caribbean is one of the most hazard-prone regions in the world. In addition, the region is heavily affected by poverty, unemployment, critical management of natural resources, and urban conglomeration in capital cities, especially in the Small Island Developing States, increasing vulnerability and risk to natural disasters and climate change. This paper examines characteristics of urban vulnerability to natural disasters and climate change in the Central America and the Caribbean Region. It argues that even though, the region is not vast in size, the diversity within creates different characteristics of vulnerability to natural disasters and thus requires an extensive variety of disaster risk reduction approaches and adaptation techniques.