This study looks at the nexus between urban growth, climate change, and flood risk in Doha, Qatar, a hot-spot, climate change region that has experienced unprecedented urban growth during the last four decades. To this end, this study overviews the main stages of Doha’s urban growth and influencing climatic factors during this period. A physically-based hydrological model was then built to simulate surface runoff and quantify flood risk. Finally, the Pearson correlation was used to verify the potential nexus between flood risk, climate change, and urban growth. Surveying showed that, between 1984 and 2020, urban areas grew by 777%, and bare lands decreased by 54.7%. In addition, Doha witnessed various climatic changes with a notable increase in air temperature (+ 8.7%), a decrease in surface wind speed (− 19.5%), and a decrease in potential evapotranspiration losses (− 33.5%). Growth in urban areas and the perturbation of climatic parameters caused runoff to increase by 422%, suggesting that urban growth contributed more than climatic parameters. Pearson correlation coefficient between flood risk and urban growth was strong (0.83) and significant at p < 0.05. Flood risk has a strong significant positive (negative) correlation with air temperature (wind speed) and a moderate positive (negative) correlation with precipitation (potential evapotranspiration). These results pave the way to integrate flood risk reduction measures in local urban development and climate change adaptation plans.