The United Nations’ Sustainable Development Goals mark a unique window of opportunity for both human and planetary health. With rising life expectancy and rapidly expanding urban populations exposed to pollution and sedentary lifestyles, there is a greater focus on reducing the gap between life expectancy and number of healthy years lived, whilst limiting anthropogenic activities contributing to pollution and climate change. Thus, urban development and policies, which can create win–win situations for our planet and human health, falls into the realm and expertise of public health. However, some of these policies have potential trade-offs in terms of associated risks. Here we review some of these opportunities and challenges related to active transport and natural environments in urban settings.