Tropical regions are characterized by high temperatures, humidity, and intense solar radiation and are disproportionately vulnerable to climate change. In these zones, rapid urbanization compounds environmental risks. Being a developing nation, the surge of urbanization along with climate change has intensified heat stress in Indian cities, where the interaction between Urban Heat Islands (UHIs) and heatwaves (HWs) threatens public health and ecological resilience. This chapter reviews UHI and HWs studies in India and their combined effect on microclimate and evaluates nature-based solutions (NBS) as adaptive strategies to mitigate these dual challenges through a systematic review of studies since 2000–2023, prioritizing Indian contexts. Findings reveal that urban green spaces, rooftop gardens, and wetland restoration can reduce ambient temperatures by 2–5 °C, though barriers like land scarcity and fragmented governance hinder scalability. Case studies from Delhi, Mumbai, and Chennai demonstrate the efficacy of NBS in enhancing thermal comfort and reducing energy demand. By bridging global evidence with localized insights, this chapter advocates for integrating NBS into urban policies and provides actionable pathways for heat-resilient urban planning in tropical regions.