This review paper is the first that summarizes many aspects of the ecological role of trees in urban landscapes while considering their growth conditions. Research Highlights are: (i) Plant growth conditions in cities are worsening due to high urbanization rates and new stress factors; (ii) Urban trees are capable of alleviating the stress factors they are exposed to; (iii) The size and vitality of trees is related to the ecological services they can provide. Our review shows, in a clear way, that the phenomenon of human-related environmental degradation, which generates urban tree stress, can be effectively alleviated by the presence of trees. The first section reviews concerns related to urban environment degradation and its influence on trees. Intense urbanization affects the environment of plants, raising the mortality rate of urban trees. The second part deals with the dieback of city trees, its causes and scale. The average life expectancy of urban trees is relatively low and depends on factors such as the specific location, proper care and community involvement, among others. The third part concerns the ecological and economic advantages of trees in the city structure. Trees affect citizen safety and health, but also improve the soil and air environment. Finally, we present the drawbacks of tree planting and discuss if they are caused by the tree itself or rather by improper tree management. We collect the latest reports on the complicated state of urban trees, presenting new insights on the complex issue of trees situated in cities, struggling with stress factors. These stressors have evolved over the decades and emphasize the importance of tree presence in the city structure.