The urban heat island (UHI) effect poses a significant and wide-ranging threat to cities. A city’s public health, air quality, energy consumption, climate adaptation, quality of life, stormwater management, and environmental justice may be negatively affected. Many cities have recognized the central role that reducing excess heat will play in meeting a variety of community goals. UHI mitigation can be incorporated into cities’ livability, sustainability, energy, or climate adaptation plans, and related initiatives have been launched. UHIs are experienced differently by each city, and approaches to tackling the problems can thus vary. Planning documents, goals, policies, and programs for UHI mitigation efforts differ across North America. This paper presents the results of a comprehensive review of the UHI mitigation strategies and programs in place in 26 large- and medium-sized North American cities. It includes an analysis of city goals, strategies, programs, policies, and other actions and, where possible, an evaluation of progress on UHI mitigation. Information was gathered through a literature review and a survey of city officials. The findings are categorized by type and city and synthesized into actionable recommendations for urban sustainability policymakers. Cities are beginning to recognize the impacts of UHI effects on their infrastructure and inhabitants. Our findings show that cities are taking action by developing strategies and policies to mitigate these effects. All of our sample cities have developed one or more strategies that include UHI mitigation and 25 have adopted at least one policy.