Historic preservation has been the subject of much debate in recent years. This paper envisions urban conservation as a culturaly sustainable process of change and development that involves restoration, demolition, renewal, and the psysical and socioeconomic impacts. The paper explores and outlines the European experience, and then investigates and analyzes a number of conservation projects in old Cairo. The aim is to delineate their positive and negative aspects within the scope of cultural sustainability. The projects examined are Arab Bureau for design and development, UNESCO, UNDP, and the Aga Khan trust for Culture (AKTC). The projects are examined in terms of physical aspects, socioeconomic and socio-cultural aspects, and actors and roles. The paper concludes a framework for sustainable urban conservation in which different actors are actively and properly involved in the development process of historic cities.