Abstract Background Climate change significantly threatens human health, particularly in vulnerable municipalities. Multiple climatic, environmental, and socioeconomic factors influence municipal vulnerability. To effectively reduce this vulnerable, evidence-based tools for local decision-makers are needed. This study aims to present the development application of a multicriteria decision analysis (MCDA) model assess vulnerability health impacts climate French Methods We selected 59 municipalities develop apply model. The MCDA involved literature review on as well active participation from an interdisciplinary committee composed members academic, associative, professional sectors. led identifying 38 indicators characterize based three components: climatic exposure, environmental sensitivity, adaptive capacity. These were used input model, which applied outranking method rank most least vulnerable. Results generated partial rankings by components vulnerability, complete ranking that integrated components. results revealed main explained allowed typology helped prioritize interventions have greatest impact each municipality studied. Conclusions highlights importance considering multiple criteria their interdependencies when assessing provide tool support decision-making processes at level. is valuable prioritizing effective studied Key messages • developed provides robust processes.