This study investigates how extreme flows in the Grote Nete watershed located in the Flanders region of Belgium will respond to climate change and urban growth using the hydrological model WetSpa. Three climate change scenarios (low, mean and high), three urban development scenarios (low, medium and high) and the nine combined climate–urban change scenarios are considered. The results indicate that extreme low flows would decrease noticeably by climate change, while they would be less sensitive to urban development. On the other hand, extreme peak flows are predicted to increase considerably due to both climate change and urban growth. It is concluded that coupling the effects of land use change with climate change may lead to severe increase in the frequency river floods in winter as well as the frequency of extreme river low flows in summer.