Climate change impacts affecting coastal areas, such as sea-level rise and storm surge events, are expected to have significant social, economic and environmental consequences worldwide. Ongoing population growth and development in highly urbanised coastal areas will exacerbate the predicted impacts on coastal settlements. Improving the adaptation potential of highly vulnerable coastal communities will require greater levels of planning and policy integration across sectors and scales. However, to date, there is little evidence in the literature which demonstrates how climate policy integration is being achieved. This paper contributes to this gap in knowledge by drawing on the example provided by the process of developing cross-sectoral climate change adaptation policies and programmes generated for three coastal settlement types as part of the South East Queensland Climate Adaptation Research Initiative (SEQCARI), a 3-year multi-sectoral study of climate change adaptation options for human settlements in South East Queensland, Australia. In doing so, we first investigate the benefits and challenges to cross-sectoral adaptation to address climate change broadly and in coastal areas. We then describe how cross-sectoral adaptation policies and programmes were generated and appraised involving the sectors of urban planning and management, coastal management, emergency management, human health and physical infrastructure as part of SEQCARI. The paper concludes by discussing key considerations that can inform the development and assessment of cross-sectoral climate change adaptation policies and programmes in highly urbanised coastal areas.