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In recent years, a noticeable contradiction has emerged between the disorderly sprawl and fragile climate environment of many cities, especially in mountainous cities. Therefore, this paper respectively constructed evaluation indicators for urban sprawl sustainability (USS) and climate change adaptability (CCA). Next, a coupling coordination degree model was used to measure the coordinated development of USS and CCA. Finally, this paper analyzed the coordinated development type of USS and CCA in the Chongqing metropolitan area from 2007 to 2017. The results of this paper show that USS and CCA have gradually shifted to coordinated development in the Chongqing metropolitan area during the study period. However, there were obvious regional differences in the type of coordinated development in the Chongqing metropolitan area. The coordinated development degree of USS and CCA in nine districts ranged from 0.635 to 0.721 in 2017. It can be divided into three types: slightly coordinated development with lagging CCA; slightly coordinated development with lagging USS; and moderately coordinated development with lagging CCA. Those districts should give priority to the use of Nature-Based Solutions (NBS), and multi-center and multi-group approaches to enhance the coordinated development between USS and CCA, which is also helpful for mountainous cities in China and other countries.