Due to the changing climate, more frequent and prolonged heatwaves are expected to have a catastrophic consequence on urban human settlement. In tropical cities such as Kuala Lumpur (KL), the quality of the urban environment is made worse by urban heat island (UHI) phenomena due to poor urban planning practices. The prolonged exposure to urban heat is hypothesized to influence human health and well-being, especially in tropical urban areas with high population density. Therefore, a study was conducted to understand the association of urban heat stress with physical, psychosomatic and psychological (PPP) health symptoms within a tropical urban setting. Continuous urban microclimate monitoring is conducted using an automated weather station to define the level of heat stress in the study area expressed as Physiological Equivalent Temperature (PET). A cross-sectional approach is used to identify heat-related health symptoms experienced by the urban population. Through exploratory factor analysis, a total of 38 PPP health symptoms are reduced into 8 heat-related health clusters which are sensory organ pain, heat-related illnesses, cardiopulmonary, pain, fatigue, anxiety, somatization, and depression-related symptoms. Heat stress was found to significantly affect psychosomatic pain (p = 0.016) as well as psychological anxiety (p = 0.022) and somatization (p = 0.041) related symptoms. Other health clusters were not significantly associated with heat stress. More studies are needed to unravel the influence of confounding factors and the long-term impact of urban heat on the health and well-being of the urban population in a tropical city.