For most urban areas, the challenges of adaptation are as urgent as those of mitigation. This is particularly the case where adaptive capacity is weak, particularly in low- and middle-income countries, and the benefits of global mitigation in the short term will be experienced beyond 2050. A focus on adaptive capacity-building in these vulnerable settings is imperative. Much of the emphasis in climate change since the early 1990s has been on basic science and how public policy should respond to it; less attention has been paid to the governance implications and connections with wider development processes. This article explores the governance challenges of adaptation in the Santiago Metropolitan Region. It points to weaknesses in the water and energy sectors, which have highly sectoral, horizontally unintegrated institutional structures and instruments that pose significant challenges for adaptation. Such cases point to the need to engage with both the wider planning concerns of existing development strategies and the basic elements of transdisciplinarity, finance and human capital-building, in order to forge a more integrated adaptation response. Without an engagement with the governance issue and wider debates around metropolitan planning and socioeconomic development, it is unlikely the response will move beyond a limited physical infrastructure investment programme.