Pluvial flooding already challenges the capacity of drainage and sewerage system in urban areas in Scandinavia. For system owners this requires a stricter prioritization when improving the systems. Experts seem to agree that a regime shift from improving old combined sewers by piped solutions to more sustainable drainage systems (SuDS), must take place. In this paper results from an investigation amongst the largest cities in Norway, Denmark and Sweden concerning drivers and preferred methods for improving the old system are presented. The results indicate that Norway ranks flood prevention lower than the other Scandinavian countries. During the last decades, Norwegian authorities have had a strong focus on pollution from wastewater treatment plants (WWTP). The attention to drainage and sewerage system regarding flooding, water leaks, infiltration or pollution has been neglected. Renewal or rate of investment in relation to existing drainage and sewerage system is easy to register, and provides a measure of the activity. In order to optimize flood prevention, and may be promoting the use of SuDS, the cities should be required to measure the efficiency, either by monitoring or modeling the impact of stormwater to the system. Lack of such requirements from Norwegian authorities seem to be a plausible explanation to why Norwegian cities are less focused on flood prevention compared to Swedish and Danish cities.