Abstract Built heritage faces increasing pressures and threats from development and change in the contemporary world, a situation that frequently results in compromise or loss of historic fabric and its associated values. This paper examines how Heritage Impact Assessment (HIA) methodology specifically addresses and mitigates threats to built heritage within an overall sustainable development framework. The methodology will be explained and examples will be given from across Asia of HIA applications to the urban and rural built environment to illustrate how this can be achieved. These case studies reflect a variety of ways in which development and heritage come into conflict and have been selected to show how versatile and adaptable HIA can be as a tool for finding balance and solutions. HIA is an approach rooted in a balanced and sustainable relationship between ‘the needs of the present and future generations and the legacy from the past’ (UNESCO 2011). The paper also illuminates some of the basic assumptions on which HIA functions and some of the contradictions that often arise when the methodology is applied to real world problems.