Climate change projections indicate that heavily populated regions across the globe will face a rising occurrence of more frequent, severe, and extended heat waves (HW), accompanied by prolonged periods of extreme heat. These events are poised to trigger widespread overheating in rural areas, leading to heat-related illnesses and mortalities. In this context, our study aimed to examine heat stress vulnerability, heat mitigation measures and indoor discomfort in rural areas. The study was carried out in the rural areas of Wardha district located in the Vidarbha region of Maharashtra, India. The census household survey method was adopted to collect quantitative data during the summer month of 2022. The environmental factors such as indoor temperature, relative humidity and dew point were measured for the period from 1st March 2022 to 30th June 2022. A total of 2,672 individuals (comprising 54 % men and 46 % women) reside in the census survey household (700 households), with 38 % of the population falling within the 21 to 40-year age group. People living in house with cement roofs were less affected with odds of 1.00 (0.78, 1.29) as compared to those with tin roofs. The highest indoor temperature was recorded in the tin roof house, reaching 40.0 °C, while cement slab houses recorded an average temperature of 38.5 °C. The highest temperatures ranged from 35 °C to 37 °C (May 11–18, 2022) and 35 °C to 38 °C (June 1–8, 2022). Notably, 80 % of individuals (2136) reported experiencing at least one self-reported Heat-Related Symptom (HRS), with symptoms such as fatigue (736), heavy sweating (679), intense thirst (518), dry mouth (364), leg cramps (255) and headache (238) were reported commonly. A small number of population experienced Severe Heat-Related Symptoms (HRS) like fainting (2), hallucinations (5) and paranoid feelings (6). While the majority exhibited Mild Heat-Related Symptoms (HRS). The mitigation strategies for extreme temperatures encompass seeking shade (1025), wearing light and loose clothing (881), drinking water frequently before feeling thirsty (802), drinking plenty of water (732), clothing removal for free air/airy dress (376) and covering head with a traditional scarf (253). Development of Heat Action Plan (HAP) will be a crucial step to avoid the HRS at local level. In the preparation of HAP engagement of local level stakeholder is very important for the effective implementation. The findings of the study will help policy makers to understand the implications of change in temperature and its consequences on the population.