While there is a great deal of confusion and debate on sustainable tourism and coastal tourism, it is clear that there is a big gap between theory and practice of sustainable tourism especially in coastal cities, and that it calls for more concerns on tourism in coastal cities because of its frangible environment and the pressure both from tourism and urbanization. With a brief literature review, the author argues that coastal environment, local community and tourism are the primary issues for sustainable tourism in coastal cities, based on which he offers a framework of sustainable tourism to achieve the balance between tourism development and environmental conservation in coastal cities. The case study of Xiamen, a coastal city in Southeast China, indicates that tourism development in the city through non-tourism efforts of gardening, forestation and environmental protection greatly, if not completely, fits the framework of sustainable and creates a symbiotic interrelation ship among local residents, tourists, tourism and environment, which will offer a more insight into congruence between theory and practice of sustainable tourism in coastal cities. Finally, related issues and further concerns about sustainable tourism in coastal cities are discussed as well.