Increasing air temperature coupled with high humidity due to ongoing climate change across most parts of South Africa is likely to induce and intensify heat exposure, particularly in densely populated areas. The adverse health implications, including heatstroke, are expected to be common and more severe during extreme heat and heat wave events. The present study was carried out to examine heat stress conditions and long-term trends in South Africa. The study aimed to identify geographical locations exposed to elevated heat stress based on over two decades of hourly ground-based data. Selected heat stress indicators were calculated based on Steadman's apparent temperature (AT in degrees C). The trends in AT were assessed based on the non-parametric Mann-Kendall (MK) trend test at 5% significance level. Positive trends were detected in 88% of the selected weather stations except in Welkom-FS, Ficksburg-FS, Langebaanweg-WC, Lambertsbaai Nortier-WC, Skukuza-MP, and Thabazimbi-LP. Approximately 47% of the detected positive trends are statistically significant at 5% significant level. Overall, high climatological annual median (ATmed) values (>32 degrees C) were observed at 42 stations, most of which are in low altitude regions, predominately along the coastlines. The hottest towns with ATmed values in the danger category (i.e., 39-50 degrees C) were found to be Patensie-EC (41 degrees C), Pietermaritzburg-KZN (39 degrees C), Pongola-KZN (39 degrees C), Knysna-WC (39 degrees C), Hoedspruit-LP (39 degrees C), Skukuza-MP (45 degrees C), and Komatidraai-MP (44 degrees C). The results provide insight into heat stress characteristics and pinpoint geographical locations vulnerable to heat stress conditions at the community level in South Africa. Such information can be useful in monitoring hotspots of heat stress and contribute to the development of local heat-health adaptation plans.