The sustainability agenda has maintained its importance since the days, when the production system took its capitalist form, as well as the population in the urban areas started to rise. Increasing number of both goods and the people have caused the degradation of the certain systems, which generate the urban areas. These systems could mainly be classified as social, environmental, physical and economical systems. Today, urban areas still have difficulty to protect those systems, due to the significant demand of the population. Therefore, studies related with the sustainable issues are significant in the sense of continuity of the urban systems. Therefore, in this paper, those studies in the context of the effects of physical decisions taken in the spatial planning process on urban sustainability, will be examined. The components of the physical decisions are limited to land use, density and design. Land use decisions will be examined in the context of mixed land use. On the other hand, decisions related with density will be analyzed in the sense of population density and floor area ratio (FAR). Besides, design decisions will be examined, by linking them with neighborhood design criteria. Additionally, the term of urban sustainability will only be limited to its social and environmental contexts in this study. Briefly stated, studies in the sustainable literature concerned with the effects of land use, density and design decisions taken in the spatial planning process on the social and environmental sustainability will be examined in this paper. After the compilation and the analyze of those studies, a theoretical approach will be proposed to determine social and environmental sustainability in the context of land use, density and design decisions, taken in the spatial planning process.