Population growth generally (urban population growth involved people migrating from the countryside); urban self-government and protection of crafts through guilds; increased trade; growth of public administration; generally more settled conditions and improved security.
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Medieval towns were crowded because serfs wanted more freedom and moved out of the manor land to towns.
Some medieval towns transportations were wagons or carriages. Some people just walked.
Regulate production or trade ;)
Many medieval towns were clean by their standards, which would have meant uncluttered, without foul odors, and so on. The medieval people did not understand anything about bacteria, viruses, and disease vectors, so in some modern senses, the towns were not clean; for example you could not trust the water.
what factors led to the development of western cities