Loreto, the largest Amazonian region in Peru, is home to more than 200,000 inhabitants that live in traditional riverside rural communities adapted to an amphibious lifestyle, with houses that rise or float on the river in times of flooding and perch on the dried riverbed in low water times. Nevertheless, these amphibious communities are not exclusive to rural areas. Iquitos, the largest city of Loreto, is surrounded by alluvial plains, where more than 90,000 people live on the water and bring a rich social, cultural, and environmental vibrancy to the regions. However, poor infrastructure conditions and limited resources in this communities affect the ecosystem and the population's health. The objective of this qualitative study was to understand the physical, sociocultural, and environmental conditions in which these amphibious communities live and identify the political, legal, and cultural barriers that prevent their healthy urban development. Data collection was conducted through semi-structured interviews, surveys, and observation of physical and environmental conditions. The results suggest conflicts in the formalization processes of theses informal communities, from administrative and legal aspects to a limited definition of habitable territory. We identified the benefits of the current urban-architectural conditions of these communities, whose housing typologies, adapted to the seasonal change of the rivers, may provide a alternative model to adapt with resilience to the impacts of climate change and sea level rise. We also identified challenges in sanitation, accessibility, public space, and strengthe of community networks, as well as challenges in the response of the government whose proposals for relocation of the amphibious communities have not fully considered these communities' economic, social, and cultural values.