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Abstract Many cities are experiencing increases in extreme heat because of global temperature rise combined with the urban heat island effect. The heterogeneity of urban morphology also leads to fine-scale variability in potential for heat exposure. Yet, how this rise in temperature and local variability together impacts urban residents differently at exposure-relevant scales is still not clear. Here we map the Universal Thermal Climate Index, a more complete indicator of human heat stress at an unprecedentedly fine spatial resolution (1 m), for 14 major cities in the United States using urban microclimate modeling. We examined the different heat exposure levels across different socioeconomic and racial/ethnic groups in these cities, finding that income level is most consistently associated with heat stress. We further conducted scenario simulations for a hypothetical 1 °C increase of air temperature in all cities. Results show that a 1 °C increase would have a substantial impact on human heat stress, with impacts that differ across cities. The results of this study can help us better evaluate the impact of extreme heat on urban residents at decision-relevant scales.