Over the last few decades, Urban Heat Stress (UHS) has become a crucial concern of scientists and policy-makers. Many projects have been implemented to mitigate Urban Heat Island (UHI) effects using nature-based solutions. However, decision-making and selecting an adequate framework are difficult because of complex interactions between natural, social, economic and built environments. This paper contributes to the UHI issue by (i) identifying the most important key factors of a Decision Support Tool (DST) used for urban heat mitigation, (ii) presenting multi-criteria methods applied to urban heat resilience, (iii) reviewing existing spatial and non-spatial DSTs, (iv) and analyzing, classifying and ranking DSTs. It aims to help decision-makers through an overview of the pros and cons of existing DSTs and indicate which tool is providing maximum support for choosing and planning heat resilience measures from the designing phase to the heat mitigation phase. This review shows that Multi-Criteria Decision Analysis (MCDA) can be used for any pilot site and the criteria can be adapted to the given location accordingly. It also highlights that GIS-based spatial tools have an effective decision support system (DSS) because they offer a quick assessment of interventions and predict long-term effects of urban heat. A comparative study using specific chosen criteria concludes that the DSS tool is well suited and fulfils many prerequisites to support new policies and interventions to mitigate UHS.