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This study identified the practices of adaptation strategies to climate change in Jimma, Bedelle, Bonga, and Sokorru urban centers using a survey of 384 households, 55 key informant interviews, 4 focus group discussions, and field observations. A cross-sectional study design was employed from 2019 to 2021. The adaptive capacity of municipalities to reduce climate extreme events was rated as poor by the majority (51%), mostly reactive measures (76%). The climate hazards identified in four urban centers were riverine and flash floods, urban heat waves, landslides, and windstorms. The urban households practiced lifestyle modification, reduce paved surfaces, the use of air conditioner, planting trees, and multiple windows. The adaptation strategies practiced by municipalities include the relocation of prone areas, the support of basic amenities, the construction of protection walls, diversion ditches, the clearance of waterways and rivers, greenery, and park development. The adaptation actions were constrained by a lack of awareness, commitment, cooperation and coordination, adaptive capacity, and participation. Gray/physical infrastructures (costly but important) as adaptation actions were hampered by the low municipal capacity. We recommend that urban authorities should incorporate climate change adaptation strategies into urban planning and development proactively to ensure future resilient climate smart urban centers of southwest Ethiopia.