The efforts made to plan cities in emerging and developing countries are confronted to multiple issues, especially in small and middle sized cities which can be considered as poor through several criteria: socio-economic level of majority of population; low levels of public investments, weak quality of local administration, and large dependence of external donors. Following several authors, one of the main reason is that philosophy and methods of urban planning applied to these specific contexts are directly reproduced from a Western tradition which doesn’t correspond to the local and national context in terms of needs, priorities and organization of the financial resources. The case of Koudougou, a medium sized city in one of the poorest countries in the world, Burkina Faso, will give the opportunity to understand concretely how these deficiencies are translated in an urban context, and foresee, more globally, alternative models of urban planning better adapted to poor cities, whose number of inhabitants is growing steadily.