Tall buildings have existed for more than 100 years and have been built in cities worldwide. Great heights only became possible after the invention of the elevator safety braking system in 1853; subsequent population and economic growth in cities made these taller buildings very popular. This chapter focuses on the specific HVAC system requirements unique to tall buildings. Stack Effect Systems System Selection Considerations Displacement Ventilation Central Mechanical Equipment Room Versus Floor-By-Floor Fan Rooms Central Heating and Cooling Plants Water Distribution Systems Vertical Transportation Life Safety in Tall Buildings