The combined effects of global warming, urbanization, and demographic change influence climate risk for urban populations, particularly in metropolitan areas with developing economies. To inform climate change adaptation and spatial planning, it is important to study urban climatic hazards and populations at risk in relation to urban growth trends and development patterns. However, this relationship has not been adequately investigated in studies dedicated to climate vulnerability. This study identifies the typologies of development patterns within Lahore, Pakistan, investigates the heat vulnerability of residents at a neighborhood scale, and establishes a relationship between both of these factors. We identified urban clusters with diverse development patterns. Fourteen context- and site-specific indicators were selected to construct a human heat vulnerability index. Weighted sum, cluster analysis, and ANOVA test of variance were conducted to analyze the data. Our results demonstrate that development patterns significantly influence human vulnerability to heat stress, e.g., vulnerability is higher in older cities and undeveloped neighborhoods with less diverse land uses. These findings are essential for informing policy-makers, decision-makers and spatial planners about proactive adaptation planning in dynamic urban environments.