Nepal’s diverse physiography, comprising the Himalayan north, hilly middle region, and Terai plains in the south, shapes distinct land use practices. Traditional wisdom in land use, driven by an understanding of the environment and disaster vulnerability, is being disrupted by rapid changes, notably driven by road construction. Linear settlements along floodplains, accelerated by road construction and hydropower projects, raise concerns about disaster risk. Challenges stem from the indiscriminate use of land, reflecting poor planning and the absence of a comprehensive land-use policy considering disaster risk. This is driven by multiple factors such as high out-migration for labor market abroad, rural to urban migration and change in livelihoods from agriculture to service-based. Policy recommendations include strategic land use planning, zoning regulations, and geographical vulnerability assessments to mitigate risks. There is need of incentives for safe settlement practices, nature-based solutions, and a strengthened legal framework to promote sustainable land use practices in Nepal.