Thermal comfort in cities is an influential factor for citizens’ wellbeing and life quality. Urban microclimate studies have gained popularity following increasing urbanization trends and global climate change in recent years. Urban fabric and morphology in traditional cities represent a unique pattern both spatially and climatically. However, few studies have investigated traditional cities’ urban thermal comfort conditions. Therefore, this study aimed to assess the thermal comfort in different subspaces of Algiers Casbah’s historic urban fabric, which falls in the hot Mediterranean climate (Csa). This research evaluated the human thermal sensation by applying the physiological equivalent temperature (PET) index. The methodology used was a mixed approach, including field measurements, calculations, and a survey questionnaire. The results indicate the presence of a high-stress level during the measurement periods, and notable differences between the subspaces in January (ΔPETMax.Jan = 3.7 °C) and August (ΔPETMax.Aug = 2.2 °C). The highest discomfort was recorded in spaces with collapsed buildings, especially during the hot hours of the day. The findings also highlight a strong impact of the sky view factor on the mean radiant temperature (Tmrt) and the physiological equivalent temperature (PET). The study discusses recommendations and ways to improve the design of outdoor spaces and relieve heat stress in the streets of traditional cities. Finally, this work helps urban managers and heritage conservators in urban rehabilitation policies concerning outdoor microclimate improvement.