In the age of globalisation and continuous urbanisation, architects have a greater responsibility to design residential buildings with comfortable and sustainable environments. However, sustainable solutions should not concern themselves only with utilising technology, but also with creating synergies amongst a community’s social, cultural, historical, and environmental aspects. This research focuses on the implications of this wider definition of sustainability within the hot-arid climates of the Middle East and North Africa. Most of the current high-rise residential buildings in these regions do not promote social cohesion as they have been constructed without consideration for local identity and lifestyle. In contrast, vernacular courtyard dwellings and neighbourhoods offer good examples of socially cohesive and healthy environments. Yet, vernacular houses might not be compatible with pressures of modern construction. The question then becomes how to maintain the relationship between the spatial, social and environmental aspects while employing the latest technologies and materials. This paper presents the different qualities of vernacular houses and neighbourhoods in the different regions of the Middle East and North Africa. Social and spatial relationships of different cases are assessed, through a typological analysis approach using a developed syntactic-geometric model, to trace the lifestyle and the cultural values of the society. The aim is a parametric exploration of appropriate sustainable solutions that facilitate the synergy of socio-climatic requirements, the well-being qualities of the residents, and the specifics of culture, time and people while designing sustainable high-rise developments.