Traditional buildings are rich in sustainability concepts. Investigating these ingenious buildings allows architects and designers to learn from the past in order to sustain buildings of the present in the uncertain future. Based on recent research projects conducted by the author in the MENA region, this paper aims to shed light on the different types of passive design devices (heating, lighting and ventilation systems) adopted in vernacular structures of the North African and Mediterranean city; “the medina”. These structures consist mainly of courtyard houses, masjid (mosques), suqs (markets) and public amenities such as madrassas (schools), bimaristans (hospitals) and hammams (bathhouses). Different passive design devices are analysed, and then re-adapted by retrofitting heritage buildings. The paper finally concludes by adopting design guidelines which aim to help develop sustainable future adaptive (re)use scenarios of „historic? buildings by integrating new technologies based on past concepts for the benefit of contemporary and future use.