Cooling centres provide respite, safety, and social support during extreme heat events for populations that do not have the resources to own or operate in‐home air conditioning. The objective of this study was to measure the spatial accessibility of cooling centres and analyze the associations between cooling centre access and marginalization in Montreal, Toronto, and Vancouver, Canada. The potential spatial accessibility of cooling centres within a 15‐minute walk was measured at the dissemination area scale using the two‐step floating catchment area method. A two‐stage modelling approach was used to analyze the associations between cooling centre access and marginalization. Approximately 62%, 58%, and 54% of the populations in Montreal, Toronto, and Vancouver had access to at least one cooling centre. In Montreal and Vancouver, high marginalization areas were more likely to have cooling centre access than low marginalization areas. Of the areas with cooling centre access, smaller access scores were observed in areas with high residential instability. Approximately one‐fifth of the areas in each city had no cooling centre access and high marginalization, and may be considered for future cooling centres or programs that improve accessibility to existing centres.