This chapter examines the World Bank’s position on ‘good urban governance’ and its promotion of urban competitiveness within a framework of globalization, and sets this against a set of recent urban interventions in the city of Medellin, Colombia’s second largest city. The case of Medellin is a valuable one to examine, not simply because it has been largely under-documented internationally, but also because it has been severely marked in recent decades by acute problems of violence, poverty, a large informal economy, and growing social and spatial fragmentation that in many ways are typical of other cities in Latin America.