Urbanization and climate change trends put strong pressures on urban water systems. Temporal variations in rainfall, runoff and water availability increase, and need to be compensated for by innovative adaptation strategies. One of these is stormwater retention and infiltration in open and/or green spaces in the city (blue–green water integration). This study evaluated the efficiency of three adaptation strategies for the city of Turnhout in Belgium, namely source control as a result of blue–green water integration, retention basins located downstream of the stormwater sewers, and end-of-pipe solutions based on river flood control reservoirs. The efficiency of these options is quantified by the reduction in sewer and river flood frequencies and volumes, and sewer overflow volumes. This is done by means of long-term simulations (100-year rainfall simulations) using an integrated conceptual sewer–river model calibrated to full hydrodynamic sewer and river models. Results show that combining open, green zones in the city with stormwater retention and infiltration for only 1% of the total city runoff area would lead to a 30 to 50% reduction in sewer flood volumes for return periods in the range 10–100 years. This is due to the additional surface storage and infiltration and consequent reduction in urban runoff. However, the impact of this source control option on downstream river floods is limited. Stormwater retention downstream of the sewer system gives a strong reduction in peak discharges to the receiving river. However due to the difference in response time between the sewer and river systems, this does not lead to a strong reduction in river flood frequency. The paper shows the importance of improving the interface between urban design and water management, and between sewer and river flood management.