New land releases in the Perth Region on Western Australia’s Swan Coastal Plain are increasingly constrained by seasonally high groundwater (within 4m of the land surface). The measurement, modelling, and management of the effects of urbanisation in these high groundwater environments remains a challenging problem. To address this problem, the Cooperative Research Centre for Water Sensitive Cities (CRWSC) funded the “Knowledge-based water sensitive city solutions for groundwater impacted developments” Integrated Research Project, IRP5. In 2019, this project convened an Expert Panel to assess best-practice, and make recommendations to land development, engineering consulting, regulatory and advisory stakeholders. The Expert Panel explored strategies for groundwater risk assessment and provided technical guidance for measuring, modelling and predicting changes in groundwater as urbanisation progresses. It also obtained extensive input from stakeholders on the need to reduce the costs and risks of urban development in sites with high groundwater. In this paper, we argue that, by integrating technical best-practice groundwater assessments with design innovations and reforms to governance, urban development on high groundwater sites on the Swan Coastal Plain can minimise the current reliance on large volumes of sand fill. Although challenging, shifting to a low-fill development paradigm would represent a triple-bottom-line “win” for developers, homeowners and the environment.