Settlements in coastal lowlands are especially vulnerable to risks resulting from climate change, yet these lowlands are densely settled and growing rapidly. In this paper, we undertake the first global review of the population and urban settlement patterns in the Low Elevation Coastal Zone (LECZ), defined here as the contiguous area along the coast that is less than 10 meters above sea level. Overall, this zone covers 2 percent of the world’s land area but contains 10 percent of the world’s population and 13 percent of the world’s urban population. A disproportionate number of the countries with a large share of their population in this zone are small island countries, but most of the countries with large populations in the zone are large countries with heavily populated delta regions. On average, the Least Developed Countries have a higher share of their population living in the zone (14 percent) than do OECD countries (10 percent), with even greater disparities in the urban shares (21 percent compared to 11 percent). Almost two-thirds of urban settlements with populations greater than 5 million fall, at least partly, in the zone. In some countries (most notably China), urbanization is driving a movement in population towards the coast. Reducing the risk of disasters related to climate change in coastal settlements will require a combination of mitigation, migration, and settlement modification.