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Real estate is a product with a high economic value, a long technical life cycle and a large spatial-physical impact. That is why it is of great societal importance to use real estate as efficient as possible. To enable a high-quality use and a high occupancy rate, a building must be able to move along with qualitative and quantitative changes in demands. In recent decades the interest in flexible building, also called adaptive building, has grown substantially. In many countries this interest is mainly caused by the structural vacancy of real estate, in particular office buildings, the economic crisis, the congestion of the housing market and the increased awareness of and interest in sustainability (Arge and Blakstad, 2010; Cairns, 2010; Horgen, 2010; Hansen and Olsson, 2011; Van Meel, 2015). A direct connection can be made between adaptive building and sustainability (Wilkinson et al., 2009; Wilkinson and Remøy, 2011). Market developments show increased demands for flexibility and sustainability by users and owners as well as a growing understanding of the importance of a circular economy (Eichholtz et al., 2008). Different actors may have different interests and needs regarding adaptability: • Users; an accommodation that is adaptable to a changing primary process; • Owners; a building with the highest possible profitability during ownership and adaptability to organisational changes such as growth or shrinkage and market change; sometimes the user is the owner as well; • Society; real estate that contributes to an attractive and sustainable living and working environment. There are three basic ways to act when a building no longer meets the users’ needs: adapt the location, building and/or unit (transformation/conversion), design and construct a new building, or move to another and more suitable existing building, see Figure 10.1. This chapter first discusses the state of the art regarding the concepts of adaptability and flexibility and the need for adaptable buildings. Then it presents possible benefits and sacrifices of typical interventions, The next section discusses ways to measure the adaptability capacity of buildings and includes both a long list and a short list of KPIs. The assessment criteria for adaptability are based on previous research by Geraedts and Van der Voordt (2007), Remøy and Van der Voordt (2007) Wilkinson et al. (2009), DGBC (2013) and Geraedts and Remøy (2014). The chapter ends with some suggestions for further research.