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Exposure to high levels of air pollution and extreme heat stress has been individually linked to significant health and economic problems in India. However, not much is known about the threats resulting from the co-occurrence of these hazards, which have common meteorological drivers. In this study, we perform a country-wide joint risk analysis at the district level, examining the risks of chronic exposure to the joint extremes of particulate matter (PM 2.5 ) pollution (PM 2.5 , mass of particles smaller than 2.5 µ m in diameter) and heat stress (wet bulb globe temperature) in the presence of geophysical and socioeconomic vulnerability. We find that northern, central, and eastern India are at alarming levels of joint risk, potentially exposing 61% (∼842 million) of the population and 56% (∼1.84 million km²) of land area. Spatially differentiated drivers of joint risk are high levels of PM 2.5 in northern India, high heat hazards in northern and eastern India, and high vulnerability in the central and eastern states of Chhattisgarh, Madhya Pradesh, Bihar, West Bengal, and Odisha. Region-specific response actions for long-term risk mitigation include reducing emissions from residential and agricultural biomass combustion and industrial coal-burning sources, as well as addressing the challenges of housing, healthcare delivery, and economic conditions in central and eastern India. A coordinated policy framework aimed at tackling individual hazards is vital to alleviating these joint risks.