The Royal Thai Government has accepted the UN SDGs 2030 to apply to multi – level strategic plans. For the Ministry of Public Health, the goals about health and wellbeing of the population, clean water and sanitation, sustainable cities and communities, and climate change are under its responsibility. Although the ministry has the framework and strategic plan for applying this goal in the multi – level health system development, the practical in the area is still mysterious. Because of this reason, this study aims to gather the various case studies about multi – level health system development that have been practiced in the operational areas. This study is based on the qualitative literature review on the document recording, experiencing, and summarization of the health system development that the Policy Research and Development Institute Foundation (PRI) has been developed, monitored, and evaluated. For the various case studies, they are mentioned on the case of Tuberculosis Screening, HIV/STI/Teenage Pregnant Prevention, Dengue fever Prevention, and Systematic Waste Management. At the end, this study could have identified the key components of the integrative urban health system development, which is the role and function of the public health staff has been shifted from practitioner to facilitator. Ultimately, this study has the recommendation on the public health policy under the decentralization in Thailand. Key Words: Urban Health, Multi – Level Health System