Photorealistic 3D vehicle models with high controllability are essential for autonomous driving simulation and data augmentation. While handcrafted CAD models provide flexible controllability, free CAD libraries often lack the high-quality materials necessary for photorealistic rendering. Conversely, reconstructed 3D models offer high-fidelity rendering but lack controllability. In this work, we introduce UrbanCAD, a framework that pushes the frontier of the photorealism-controllability trade-off by generating highly controllable and photorealistic 3D vehicle digital twins from a single urban image and a collection of free 3D CAD models and handcrafted materials. These digital twins enable realistic 360-degree rendering, vehicle insertion, material transfer, relighting, and component manipulation such as opening doors and rolling down windows, supporting the construction of long-tail scenarios. To achieve this, we propose a novel pipeline that operates in a retrieval-optimization manner, adapting to observational data while preserving flexible controllability and fine-grained handcrafted details. Furthermore, given multi-view background perspective and fisheye images, we approximate environment lighting using fisheye images and reconstruct the background with 3DGS, enabling the photorealistic insertion of optimized CAD models into rendered novel view backgrounds. Experimental results demonstrate that UrbanCAD outperforms baselines based on reconstruction and retrieval in terms of photorealism. Additionally, we show that various perception models maintain their accuracy when evaluated on UrbanCAD with in-distribution configurations but degrade when applied to realistic out-of-distribution data generated by our method. This suggests that UrbanCAD is a significant advancement in creating photorealistic, safety-critical driving scenarios for downstream applications.