Background: Double burden of malnutrition (DBM) is an emerging public health problem in urban settings where both undernutrition and obesity exist. This complex phenomenon is caused by socioeconomic disparities, urbanization, and dietary transitions, with women and children being proportionately affected. This study reviews the drivers of DBM and evaluates suitable mitigation strategies. Methods: A comprehensive review was performed using studies published between 2014 and 2024. Peer-reviewed articles examining the drivers, interventions, and outcomes of DBM within urban contexts were the target inclusion criteria. Data were extracted on location, target populations, methodologies, key drivers, interventions and outcomes which were then synthesized using thematic analysis. Results: Eighteen studies from Sub-Saharan Africa, Southeast Asia, and Latin America were included. Drivers known to be common among the reviewed studies include income inequality, poor dietary diversity, and cultural food practices that are further worsened by urbanization and sedentary lifestyles. By region, effective mitigation strategies included maternal nutrition literacy programs in Southeast Asia and Sub-Saharan Africa and taxation policies against unhealthy foods in Latin America. Gaps were identified in the areas of policy implementation and program scalability. Conclusion: Integrated, double-duty actions are needed to address the double burden of malnutrition in urban contexts. However, policy reform, community-based nutritional programs and educational initiatives targeted at vulnerable populations, are essential. Longitudinal and gender-specific research should be prioritized in assessing DBM’s trajectory and informing future sustainable interventions. The findings from this study offer actionable insights for policymakers and public health practitioners working to eliminate DBM in urban settings.