Climate change and continued urban development in flood-prone areas exacerbate flood risks. Flood Risk Management authorities often turn to structural protection measures to minimise losses. However, these measures often lead to infrastructural lock-ins with potential unintended consequences as increased safety can induce increased development, ultimately leading to higher losses in the event of failures of the structural safe-guards in place. This process has been referred to as the Safe Development Paradox: a cross-cutting science-policy-practice challenge that requires a systematic understanding in the context of climate change and the United Nations Sustainable Development Goals. Yet, there are no comprehensive review studies, to date, that summarize the state of knowledge of the Safe Development Paradox. This paper provides the first evidence base through a critical review of the state-of-the-art and quantitative analysis of the peer-reviewed English-language literature since 2000, highlighting key knowledge gaps and issues hindering progress in addressing the Safe Development Paradox. It was identified that current research is compounded by a lack of consistent terminology, limited geographic distribution of case studies, and skewed emphasis on fluvial flooding. The review ends with potential directions across the science, policy, and practice domains for increasing knowledge and tackling the Safe Development Paradox.EPSRC grant number EP/T518116/