This report has analysed Nairobi’s politics of development, key challenges, and opportunities for equitable change. We conducted four domain studies focused on housing; safety and security (S&S); health, wellbeing and nutrition (HWN); and structural transformation (ST) in Nairobi. To deepen understanding of these domains, we offer a political settlements analysis and “city of systems” examination of major infrastructure networks. We argue that Kenya has a “broad-dispersed” political settlement, characterised by shifting ethnic alliances, crony capitalism and competitive elections that still maintain a narrow elite in power. Given Nairobi’s centrality to the Kenyan economy, it acts as a key battleground and hub for business networks, which the elite regularly exploit to generate rents. Colonial legacies strongly shape Nairobi’s contemporary development, even as the city radically stretches the spatial boundaries and capacities of many institutions it has inherited. Nairobi faces an increasingly complex set of socioeconomic, health and spatial inequalities that are manifested in rising burdens of poor nutrition and chronic diseases, as well as new forms of unsafe, low-quality housing (such as tenements). Our findings indicate that poorly integrated, low-quality systems have major negative knock-on effects for housing, HWN, ST and S&S, which especially burden Nairobi’s low-income residents. More positively, we identify several opportunities for holistic, joined-up interventions that can foster inclusive urbanisation pathways in Nairobi. There are vibrant policy networks, start-ups and mobilised civil society actors, which together make Nairobi a particularly fertile ground for innovations and reform coalitions.