Floods are the most frequent disasters in the world with devastating effects on millions of people and the natural environment. The health status of any community is directly affected by the quality of their housing and the environmental risks they are exposed to. Rapid urbanization and the inability of the government to meet with the high demand for housing has led to the formation of informal settlements resulting in the unsustainability of cities due to overcrowded housing, poor sanitation, poor collection of solid waste, blocked drainage system as well as poor healthcare and compromised healthcare delivery system. The impact of floods on informal settlement dwellers is becoming increasingly severe and frequent. Using multiple data sources, this study critically evaluates eThekwini metropolitan area. The review shows that eThekwini has the largest number of informal settlements in south Africa characterized by poor housing conditions, inadequate infrastructure, unhealthy natural environments and poor health services predisposing them to increased risk of diseases and poor wellbeing, which is exacerbated during flood disasters. The findings of this study advocate for improved governmental involvement in service delivery, risk informed decision-making concerning floods, public health and affordable housing for residents of informal settlements in eThekwini metropolitan area.