As shown throughout this book, urbanization moulds evolutionary processes in many biological systems. But what are its effects on the species that is itself the cause of this radical habitat modification? At least two major cultural transitions in history have involved urbanization: the transition to agriculture, and the continuing transition to modernity. Humans both endure and create the selective pressures associated with urbanization, a process of niche construction with complex evolutionary consequences. Urbanization modifies extrinsic mortality, nutrition, hygiene, demography, the toxicity of air, our microbiota, social interactions, and other factors known to shape selection on morphological, physiological, immunological, life-history, and behavioural traits. Today more than half of humanity lives in cities and is exposed to this new evolutionary context. This chapter presents the elements needed to understand the evolutionary potential of humans living in cities, focusing on traits affecting health. Urbanization can alter the expression of tradeoffs and the selection on traits in ways that change the prevalence of both infectious and non-communicable diseases. The chapter identifies several challenges for research. These include the difficulty of separating the effects of urbanization per se from those of modernization in general, and the need to better integrate eco-evolutionary feedbacks, culture, and learning into microevolutionary models to understand how urban life modifies selection on health. Finally, the chapter discusses why the application to humans of gene editing technologies, such as CRISPR-Cas9, is likely to interact with natural selection, an issue deserving closer attention from evolutionary biologists.