Wildland firefighting involves prolonged, high-intensity physical work performed under hot, variable, and operationally demanding conditions, placing firefighters at substantial risk of heat-related illness. This paper synthesizes current evidence on the mechanisms, contributing factors, and management of heat stress in wildland firefighting, with a specific focus on physiologically and operationally relevant considerations aligned with NIOSH, NFPA, and USFS guidelines. Heat stress is conceptualized as a cumulative process resulting from the interaction of metabolic heat production, environmental heat load, protective clothing, and individual susceptibility. Key environmental contributors include high ambient temperatures, humidity, and solar and fire-related radiant heat, while occupational demands such as sustained heavy work, extended shift durations, limited recovery, and the thermal burden of personal protective equipment further exacerbate risk. Individual factors—including fitness, hydration status, acclimatization, fatigue, and underlying health conditions—modify heat tolerance and vulnerability. This review highlights evidence-based exposure management strategies tailored to wildland fire operations, including work–rest cycles, heat acclimatization protocols, and practical cooling interventions, and addresses the operational constraints that shape their implementation. This paper further emphasizes the role of standardized training programs in prevention, early symptom recognition, and rapid response. Together, these integrated approaches provide a focused framework for reducing heat-related morbidity and enhancing wildland firefighter safety.