Abstract: Coastal areas are pivotal to China′s economic and industrial development, marked by high population density and intense land use. However, the compounded effects of global climate change and rapid urbanization have led to a growing frequency of both inland and marine hydrometeorological disasters. These events increasingly threaten urban public safety and constrain the sustainable development of the economy and society in coastal regions. In this study, we systematically review the topographic, climatic, and hydrological conditions of coastal cities and examine the evolving characteristics of runoff generation and concentration under changing environmental stressors. The application progress of engineering measures, non-engineering measures, and ecological comprehensive measures for urban flood control and drainage is summarized and future prospects are forecasted. The findings indicate that flood disasters in China′s coastal cities are governed by a complex interplay of climate variability, intensified urbanization, and the coupled interactions between terrestrial and marine hydrological systems. The increasing frequency of short-duration heavy rainfall, the limited capacity of urban drainage infrastructure, and the backwater effects of tidal influence have collectively increased surface runoff, accelerated confluence processes, and heightened flood and waterlogging risks at both urban and watershed scales. Innovative strategies such as sponge city construction, intelligent drainage regulation, and watershed-urban coordinated scheduling offer promising pathways for urban flood control and drainage systems. Nevertheless, existing planning frameworks and drainage governance systems face persistent challenges, including misaligned technical standards, limited inter-regional coordination, and insufficient operational precision. To address these gaps, the deep integration of artificial intelligence, big data analytics, and digital twin technologies presents significant potential to transform urban flood prevention and waterlogging control systems. These technologies can enable more adaptive, intelligent, and resilient urban water management, thereby strengthening flood response capacity and long-term water security in coastal cities.