The High-level Conference on Public Health Emergencies in Urban Areas: Challenges and Opportunities, that took place in Lyon, France, on 3–4 December 2018, brought together nearly 200 participants from 29 countries, representing international and national organizations, cities, nongovernmental organizations and the private sector. The programme addressed pressing issues in urban preparedness, with the IHR (2005) as the overarching framework for public health security. The objectives were to provide a forum for sharing experience at local and national levels in preparing for and responding to infectious disease outbreaks and other public health emergencies and to discuss increasing global connectivity in urban areas as both a dynamic for human development and a trigger for new public health challenges, as well as local coordination at the health–transport–tourism interface. The Conference also addressed strengthening multi-sectoral preparedness for public health emergencies in urban areas by the whole of society, with cohesive local, national and international approaches and political commitment to foster sustainable global partnerships beyond the public health sector, thus contributing to attainment of the Sustainable Development Goals (SDGs). At the conclusion of the Conference, a statement was issued on preparedness for public health emergencies in urban areas.