We live in a rapidly urbanizing world. In the next 30 years, 70 million people will move to urban areas every year. By 2050, two-thirds of the global population will live in cities. This rapid urbanizing, expected to continue in the coming decades, so cities face human pressure on its vital infrastructure and social care services and the natural pressure of climate change which set to intensify these existing social and economic challenges.  There are physical impacts of these pressure on human health, quality of life, and business life. Therefore, most cities around the world had announced the challenges against the growth and what should be done. The research presents and analyzes the phenomena "cities under pressure" from all aspects and their impacts on citizens. Then moving to the empirical study of Nasr City, one of Cairo's districts to monitor the extent of the pressures and evaluate it to find keys guides for a comprehensive strategy with Executive steps to improve the quality of life and help for working towards sustainability.