Property economics favours the vertical develop- ment of cities but flow of groundwater can be affected by the use of underground space in them. This review article presents the state of the art regarding the impact of distur- bances caused by underground structures (tunnels, basements of buildings, deep foundations, etc.) on the groundwater flow in urban aquifers. The structures built in the underground levels of urban areas are presented and organised in terms of their impact on flow: obstacle to the flow or disturbance of the groundwater budget of the flow system. These two types of disturbance are described in relation to the structure area and the urban area. The work reviewed shows, on one hand, the individual impacts of different urban underground structures, and on the other, their cumulative impacts on flow, using real case studies. Lastly, the works are placed in perspective re- garding the integration of underground structures with the aim of operational management of an urban aquifer. The literature presents deterministic numerical modelling as a tool capable of contributing to this aim, in that it helps to quantify the effect of an underground infrastructure project on groundwater flow, which is crucial for decision-making processes. It can also be an operational decision-aid tool for choosing construction techniques or for formulating strategies to manage the water resource.