Southeast Asia is one of the regions in the world which will be hardest hit by climate change. The main impacts in Malaysia will be increasing temperatures, increasingly frequent and severe extreme weather events as well as sea level rise. Over the past 3 years, the City Council of Penang Island, the Department of Irrigation and Drainage, Think City and UN-Habitat have developed a nature-based climate adaptation programme for the urban areas of Penang Island. The programme has already been recognised internationally, and an application in partnership with UN-Habitat for funding from the World Bank’s Adaptation Fund has been endorsed and approved for implementation. The programme will pioneer the use of Nature-Based Solutions in Malaysia. It is designed to be demonstrative with a strong knowledge codification so that it can be scaled in Malaysia and elsewhere in the region. It is structured around four key components addressing the issues of heat stress and flooding whilst strengthening social resilience and institutional capacity.