Urbanization can drive economic growth but also increases spatial pressure, environmental risks, and disparities in access to urban services. This research examines how economic structure, investment orientation, and governance capacity shape inclusive and sustainable urbanization in Medan, using Bangkok and Marseille as comparative cases. The study employs a mixed-methods comparative approach, integrating a weighted assessment of ten indicators across governance, investment, economic drivers, and inclusive urbanization, alongside document analysis, GIS-based land-use analysis, and VOSviewer keyword mapping from Scopus and Web of Science. Findings indicate that Medan achieved 5.07% economic growth in 2024, primarily driven by trade, construction, manufacturing, and service sectors. However, the composite assessment reached only 3.00, reflecting challenges within Medan’s rapidly evolving urban and environmental spatial structure. Governance and inclusive urbanization scored 2.67 and 2.33, respectively, while investment and economic drivers attained 3.50. Settlement land increased from 18,205.50 ha in 2011 to 20,705.31 ha in 2025, demonstrating significant spatial transformation. Comparative literature analysis shows a greater focus on future mobility and environmental adaptation in Bangkok, whereas research on Marseille emphasizes governance, social inclusion, and sustainability. Overall, the results suggest that economic growth alone is insufficient for achieving inclusive and sustainable urbanization; enhanced green investment, affordable mobility, integrated governance, and spatial coordination are essential.