Rice cultivated in the tropics is exposed to high temperature (HT) stress which threatens its growth and survival. This study aimed at characterizing the HT response in terms of PSII efficiency and membrane stability, and to identify leaf fatty acid changes that may be associated with HT tolerance or sensitivity of rice genotypes. Twenty-eight-day-old seedlings of two Thai rice cultivars (CN1 and KDML105), a standard heat tolerance (N22), and a heat sensitive (IR64) rice genotype were treated at 42 °C for 7 days. Under HT, N22 showed the highest heat tolerance displaying the lowest increase in electrolyte leakage (EL), no increments in malondialdehyde (MDA) and stable maximum quantum yield of PSII efficiency (Fv/Fm). Compared to KDML105 and IR64, CN1 was more tolerant of HT, showing a lower increase in EL and MDA, and less reduction in Fv/Fm. N22 and CN1 showed a higher percentage reduction of unsaturated fatty acids (C18:2 and C18:3), which are the major components of the thylakoid membrane, rendering the optimum thylakoid membrane fluidity and intactness of PSII complex. Moreover, they exhibited sharp increases in long-chain fatty acids, particularly C22:1, while the heat sensitive IR64 and KDML105 showed significant reductions. Dramatic increases in long-chain fatty acids may lead to cuticular wax synthesis which provides protective roles for heat tolerance. Thus, the reduction in unsaturated fatty acid composition of the thylakoid membrane and dramatic increases in long-chain fatty acids may lead to high photosynthetic performance and an enhanced synthesis of cuticular wax which further provided additional protective roles for heat tolerance ability in rice.