Extreme heat adversely affects cardiovascular, respiratory, renal, and mental health outcomes, with disproportionate impacts on vulnerable communities and unique risks for those in urban settings. The goal of the study was to examine how community members in Baltimore City, Maryland, perceive the links between extreme heat and health and solutions to extreme heat. We conducted in-depth interviews with 21 residents recruited from diverse neighborhoods in Baltimore City. Using thematic analysis, we identified adverse behavioral (e.g., increased violence), environmental (e.g., natural vegetation loss), health (e.g., increased anxiety), and financial (e.g., increased utility bills) impacts of extreme heat, along with strategies to cope with extreme heat. Current strategies and potential solutions to support adaptation to extreme heat in Baltimore City included minimizing energy use, ensuring access to resources to cope with heat, enacting laws and regulations to support climate change mitigation, and improving community infrastructure. Our results highlight the need for holistic urban policies to address the multifaceted impacts of extreme heat on physical and mental health by considering strategies proposed by community members, such as providing energy bill discounts, ensuring resource access (e.g., financial assistance to access/install air conditioning) and improving infrastructure to enhance overall heat resilience in Baltimore City.