This article reviews water-related urban environmental conditions in Southeast Asia. It argues that the development of urban environmental challenges in the region follows a unique pattern compared with those experienced in the now developed world. The new pattern is defined by the so called time–space telescoping of the development process. The process of time–space telescoping reduces the levels of income at which environmental challenges emerge and forces their appearance in a simultaneous fashion, as sets of problems. During previous eras, cities experienced sequential environmental transitions. Urban water-related environmental burdens emerged on local scales and expanded geographically and temporally in impact, with growing levels of affluence. Moreover, certain environmental challenges appeared later in economic growth because the technologies and practices that induced these problems emerged at higher levels of income. The article has two main findings. First, except for wealthy urban centers, for example Singapore, cities in the region are experiencing multi-scaled water burdens simultaneously. Second, low-income and middle-income cities are experiencing burdens at lower levels of income than did their contemporaries in the north.