Recent studies have suggested a city‐region’s competitiveness is based not only on production, but social reproduction. These issues as well as the policy measures adopted by many city‐regions are frequently couched in a discourse of ‘sustainable development’. But as an analytical framework how well does the concept of sustainable development account for the dynamics of social reproduction and the sustainability of a city‐region? This article examines the possible relationship between city‐regions and sustainable development at a conceptual level. We argue that despite some excellent work on the concept of ‘just sustainability’, current constructions of sustainable development are inadequate to capture the broad array of social and economic issues found in the city‐region. As a way forward we initiate a discussion between the sustainability literature and labor geography, and provide a case study of a hospital privatization process in Boston, USA, which has been framed by a politics of city‐regionalism.