The concept of urbanization has long been used to refer to the growth of cities in a particular region. The definition of a city is notoriously vague, however, and as such using their growth as a mechanism for understanding urbanization is highly problematic. In addition, the sequence of events leading to the urbanization of a region does not indicate that cities necessarily lead to the effects with which urbanization is commonly associated, but rather these “effects” predate and even facilitate the growth of cities. This paper discusses the concept of urbanization in light of two very distinct case studies of the sequence leading to the growth of cities: that of “pristine urbanization” in the ancient Fertile Crescent and of later urbanization in the American Northeast.