Tracy K. Betsinger and Sharon N. DeWitte bring a much-needed compilation of bioarchaeological work that considers that hallmark of modern life—urbanization. Although scholars have tackled the biological consequences of living in dense aggregation, it has not been thoroughly considered or theorized in the way that this fascinating volume achieves.

The volume begins with a review centering the broad effects of urbanization. By surveying impacts in the context of contemporary studies, Betsinger and DeWitte highlight a range of outcomes for modern city dwellers. They make comparisons with rural populations and look at the broad geographic sweep of human occupation. In doing so, they bring older works that tackled urbanization into conversation with their ideas. They make a point to address the important fact that “urban” itself denotes different things in space and time, a factor that affects the way we consider studies of urbanization in the past. As a stand-alone piece, this excellent introductory chapter serves to make the claim that there is no unilateral response to urbanization. Rather, different human groups experiencing different environments and constraints fare in different ways. It also lays the groundwork for the myriad chapters that form the bulk of the volume. Betsinger and DeWitte look beyond the arcane to open bioarchaeology to considering the world today.

Structurally, the book is divided into three thematic sections—“Early Urban Centers,” “Medieval and Post-Medieval Cities,” and “Premodern and Industrial Cities.” It is not only time that distinguishes these case studies but also size, specialization, and centralization. The volume is notable for the diversity of approaches presented, ranging from traditional osteological methods and broad assessments of mortuary context to newer technologies. There are a number of strong pieces, and I highlight two that stood out to me. Gwen Robbins Schug's treatment of Harappan urbanization (Chapter 3) brings together innovative aspects of bioarchaeological work. Here, she contemplates aspects of the mortuary context with the body—combining pathological findings, analyses of health, and study of objects to discuss the diverse integration of ritual and quotidian in the urban Bronze Age. She argues that, likely because of a varied migration history, “the city's inhabitants largely did not share ethnic or community membership, histories or sociocultural traditions, spiritual or ritual practices” (p. 66), and she then takes this notion of population flow to not only account for the heterogenous quality of cities but also provide some logic for the ease with which they could have been abandoned.

Anna Kjellström's work on emerging urbanization in Sigtuna, Sweden (Chapter 6)—a contrasting approach—compares life in this town to the preceding Viking era and a contemporary rural setting, using multiple lenses to do so. Kjellström takes aDNA analyses and stable isotope analyses of carbon and nitrogen to explore this society, revealing kinship and mobility networks, generalized cultural homogeneity, and incipient social stratification and gender differences. Moreover, she brings in paleopathological analyses to add more nuance to our understanding of this town. She integrates this with information about the cemeteries themselves, considering varied mortuary spaces in her analysis. Ultimately, this multimethod synthesis provides an deeper understanding of the people who lived in this growing urban space.

Unsurprisingly, the book does not reach a cohesive conclusion about the effects of urbanization given the breadth of the reality of what is urban. That said, Charlotte Ann Roberts's concluding chapter works well to bring together the pieces of the volume. She frames her evaluation of how we understand “urban health and well-being” in the context of the COVID-19 pandemic. The fact that the contemporary world is massively urbanized serves as a touchstone as well, allowing Roberts to move back and forth between urban and rural, archaeological and contemporary. She notes three themes of salience that stand as potential foci for future work: migration and immigration, food provisioning, and air quality and respiratory health. Additionally, she smartly problematizes the understanding of urban health by bringing in the intersectional nature of identity, the contingency of human movement between urban and rural settings, and the ways that this type of work is of relevance as we move forward into an increasingly urbanized world.

In sum, the authors have pulled together a broad and important range of work that tackles the minutiae and the overarching patterns of the impact of urbanization on human bodies. Although I would have liked to have seen a more significant integration of the Americas into this treatise, the foundational work done here will likely serve to support the growth of the field and solidify the ways that bioarchaeology can contribute to our understanding of the large impacts of the kinds of lives many of us live today.