The extent of extremely high temperature is expanding under global climate change. The adverse effects of high urban temperatures are worsening, presenting great danger to the environment and human society, and are especially pernicious to urban human- environment compound systems. Adaptation is an important action to cope with the extremely high temperature, and the studies of high temperature vulnerability coupled with the adaptability factors have become the international hot spots and research frontiers. Fuzhou city, one of the high temperature cities in China, was evaluated as a case study in this research. Expert evaluation, analytic hierarchy process (AHP), geographical spatial analysis technologies, questionnaire survey and orderly multivariate logistic regression analysis were used to reconstruct the spatial evaluation index system of urban high temperature susceptibility of coupling adaptability. In this study, the high temperature vulnerability of Fuzhou, its spatial differentiation, scale dependence, hot spots and the influencing factors of adaptability were systematically evaluated. The results indicated that: (1) Six selected indices, namely age, housing area, out-of-home cooling frequency, health condition, degree of medical convenience and government efforts to alleviate the high temperature, had significant impact on city residents' adaptability. (2) The spatial distribution of urban high temperature vulnerability, exposure and adaptability in Fuzhou showed a spatial structure of "core- periphery", and the high temperature vulnerability of Fuzhou showed the semi- enclosed spatial pattern with the characteristics of "high near the outer and low near the inner area". (3) Under the same background of regional high temperature exposure and susceptibility, the adaptability from individual to community and city government could significantly change the spatial distribution of urban high temperature vulnerability. The research results are expected to further the theoretical progress of urban high temperature vulnerability, and to provide the basis of decision-making for Fuzhou and other cities of the same category.