Extreme heat is considered the number one cause of weather-related mortality in the United States. The urban climate, especially the urban heat island, can provide an exacerbating effect on such events. Moreover, there is a significant socioeconomic component to vulnerability that can be linked to environmental variables attained via remote sensing. Even though heat is considered a major public health concern, Indianapolis, IN has been spared a major health-related disaster compared to Chicago, IL and St. Louis, MO. This presentation will examine the changes in extreme heat vulnerability within Indianapolis from 1990 until 2010. During this time there has been dramatic shifts in the urban heat island and socioeconomic vulnerability. Such investigations can provide insight into mitigating extreme heat vulnerability and adapting to climate change scenarios that indicate an increase in the frequency of extreme heat events.