Globally, rising seas, coastal erosion, extended dry periods, and flooding contribute to decreased water security and increased disaster incidence. Nature-Based Solutions (NBS) are increasingly advanced as innovative responses to promote adaptation and build resilience, and they are arguably more sustainable than traditional gray infrastructure. There is a growing body of information regarding the material, social, and technological advances that constitute NBS and the ways in which nature can complement traditional built infrastructure. However, critical gaps remain. Promoting a coupled systems approach, we explore fundamental challenges, including issues of participation and equity, economic valuation, scalar mismatches, the integration of natural and built infrastructure, and governance. NBS do not entail quick solutions, and to reach their full potential NBS require a fundamental rethinking of society's relationship with nature. Addresses