Urban policymakers, researchers, and municipal planners increasingly face the challenge of managing complex sustainability transitions, particularly in contexts involving persistent environmental hazards such as asbestos contamination. This systematic review applies the Multi-Level Perspective (MLP), which examines interactions between niche innovations, socio-technical regimes, and broader landscapes, to the underexplored area of asbestos-free urban transitions. The concept of an “asbestos-free city” is introduced in this paper as a novel analytical lens to describe urban transitions aiming to eliminate asbestos-related risks through systemic, sustainable interventions. The review was conducted through a structured qualitative analysis of peer-reviewed academic literature, guided by predefined thematic criteria and relevance to urban asbestos-related transitions. The review highlights the factors that enable or hinder the adoption of asbestos-free and strong sustainable solutions, as well as the role of various actors, such as policymakers, industry, and civil society, in driving these transitions. Despite the growing body of work on sustainability transitions, the integration of MLP into asbestos-related urban transformation remains limited. This paper fills that gap by offering a structured synthesis and proposing a roadmap for future research and practice. Our findings provide actionable insights for actors across policy, civil society, and industry seeking to accelerate transitions toward asbestos-free and sustainable cities.