One of the most important criteria for a city’s sustainability is climate adaptation. Simultaneously, traditional cities in West Asia have achieved harmony between architecture and the environment, depending on the experience and culture of the local community, indicating a fundamental stage of adaptation to the environment and climate. This research attempted to study and examine the traditional urban fabric, in order to diagnose its significance and ability to solve contemporary problems, such as the lack of comfortable and suitable urban housing environments in hot–dry climate areas, which cover most of West Asia. We used two research methods to create an integrated vision to investigate the indicators and their effect on urban form. Four case studies in the urban fabric and housing communities of West Asia’s hot–dry research areas were chosen for the analytical study. Furthermore, inductive analysis was carried out to determine the most critical sustainability parameters in the particular urban fabric. The climate response parameters of the study cities were evaluated using Ecotect simulation tools, and the determinants of sustainability indicators were quantitatively evaluated to assess each indicator’s impact on the sustainability of the urban fabric. Our findings have implications for assessing the relevance of climate adaptation in the sustainability of cities and their effectiveness in combating the impacts of climate change.