This study develops a structured framework for measuring regional resilience in Egypt's medium-sized city regions, focusing on economic, environmental, and social vulnerabilities. Using the 4Rs model -Risks, Resistance, Robustness, and Recoverability- the research constructs a composite index using socio-economic, infrastructural, and institutional indicators. Analysing 37 city regions across 17 Egyptian governorates reveals significant resilience disparities. Governorate capitals and well-connected city regions demonstrate stronger resilience due to more robust economic bases and governance structures. In contrast, peripheral regions face high vulnerability due to weak institutional capacity and limited economic diversification. The results highlight a critical imbalance between resistance and recoverability, while some regions recover quickly, they remain susceptible to recurrent disruptions. The measurement model and classification framework aim to support policymakers in identifying at-risk areas and potential regional growth centres, enabling more effective resilience strategies. By embedding resilience thinking into urban and regional planning, the findings contribute to a more adaptive and sustainable regional development approach for Egypt's medium-sized city regions.