Urban sprawl and increasing population pose a significant problem for sustainable development of cities. The present research focuses on analyzing urban growth and spatial patterns in Abha and its surrounding cities of Asir region of Saudi Arabia during the period 1990-2018. Landsat satellite data used to prepare LULC maps for the years 1990, 2000 and 2018 using maximum likelihood supervised classification. The study uses a combined approach of several spatial, urban metrics and landscape expansion index to quantify the growth patterns, expansion approaches and spatial extent of urban areas. A massive increase of +389% in built-up area is observed over temporal scale under investigation. The conversion of the natural landscape to built-up is observed as the leading cause of urbanization. It is found that the outlying method of urban expansion is the most dominant, followed by edge-expansion and infill. Spatial metrics show dispersion at the outlying and accumulation in the centre. It was observed that rate and intensity of urban expansion and sprawl is recorded to be higher during 2000-2018 in comparison to 1990-2000. Assessing land-use changes and urbanization growth trends using integrated spatial approaches are helpful in planning and resource management in the region for the present and future.