Flooding in the Kathmandu Valley has intensified in recent years due to rapid urbanization, unregulated land-use change, and insufficient drainage infrastructure. Existing flood hazard assessments are often based on low-resolution datasets and lack proper field validation. This study presents an integrated flood modeling framework that combines Unmanned Aerial Vehicle (UAV)-derived Digital Elevation Models (DEMs), field-based flood measurements, and hydrological simulations to assess urban flood hazards in the Bagmati-Nakkhu confluence, Nepal. High-resolution UAV-derived DEM and field survey data, including flood marks and high-water levels, were used as the foundation for the analysis. Hydrological modeling was conducted using the Hydrologic Engineering Center—Hydrologic Modeling System (HEC-HMS) to estimate the peak discharges of the Nakkhu River (2000–2024), which were then used to derive design flows for return periods of 5 to 150 years using the Gumbel distribution. These flows were used as boundary condition inputs for the Hydrologic Engineering Center—River Analysis System (HEC-RAS) to simulate flood depth and inundation extent under different scenarios. Flood extents for the 27 September 2024 event were derived from Sentinel-2 imagery and validated against surveyed flood marks. Additionally, land use/land cover (LULC) mapping based on UAV data was used to support flood impact analysis. The results show that flood depths ranged from approximately 0.5 m to 2.8 m, with inundation areas increasing by 35–50% under extreme rainfall. Model validation demonstrated strong agreement with simulated results, with deviations generally within ±0.3–0.5 m. Scenario analysis further indicates that urban expansion significantly increases runoff and flood extent, particularly in low-lying areas near the river confluence. Socio-economic exposure analysis for the 27 September 2024 event indicates that approximately 2569 residents (56.4% of the study zone population) and 4.011 km (77.42%) of the local road network were exposed to inundation. Overall, the results demonstrate that integrating high-resolution UAV data, field observations, and hydrological modeling greatly improves the accuracy and reliability of flood hazard assessments in data-scarce urban environments.