Climate change (CC) and air pollution (AP) are critical concerns, especially in rapidly urbanizing Indian cities. This review highlights the severe health threats of extreme climate events like heatwaves, heavy rainfall, floods, and droughts, which get intensified by increasing temperatures (temp.s). Urbanization combined with excessive weather volatility like heavy rainfall, rising temp.s, flooding, and drought have raised health risks for city residents. Prolonged and intensified heatwaves related to CC have contributed to thermal distress and other heat-associated health issues. The review also emphasizes exacerbating air quality (AQ) in Indian metropolitan cities, where levels (lvl.s) of pollutants consistently surpass national standards. Particular emphasis is given to aerosols and particulate matter, which pose severe health threats on inhalation and absorption by the respiratory tract. The complex interaction between urbanization, CC, and AP is also discussed because air pollutants influence the Earth’s climate. The current study tries to offer a point of reference for policymakers to locate hotspots and execute targeted mitigation and adaptation strategies to address both climate-associated health effects and AP in Indian urban cities.