The present chapter explores opportunities and challenges of an integrated vision of economic growth, the related social dynamics, and their intrinsic nexus with the dimension of environmental quality. Assuming a ‘pre-sustainability’ vision with a focus on urban areas and metropolitan regions, a concise theoretical background on economic growth—starting from traditional models of capitalistic accumulation and the role of agglomeration and scale factors—was provided. Social dynamics were also discussed focusing on their (explicit and latent) role in the long-term evolution of territories and local districts. A brief discussion on the ecological dimension of regional development demonstrated how environmental aspects reflect the impact of economic growth (via negative externalities of capital accumulation and agglomeration/scale factors), and the non-negligible role of social dynamics (via individual behaviors, changing lifestyles, and latent transformations of local communities). With this perspective in mind, implementation of strategic measures reconciling environmental quality with economic growth, particularly within metropolitan regions, is imperative in the present territorial setting.