The vast majority of studies on heat-related mortality are focused on large cities. The aim of this study is to fill this research gap and to estimate the impact of high temperatures on the risk of death in smaller towns and villages. The results show that increased mortality is not only a problem in large cities. The risk of death, although usually slightly lower than in highly populated areas, may be higher for the age-related risk group. At temperatures above 35 degrees C, it may exceed 1.3 in smaller towns and even 1.6 in villages. The increase in mortality during five selected heat waves of high intensity and long duration was also studied for two regions of Poland: Malopolska and Wielkopolska. Towns with a population of less than 10,000 in Malopolska region, during the 2006 heatwave, experienced an increase in the number of deaths by as much as 18%. At the same time in the largest city of Malopolska-Krakow, the death toll rose by 4%. This paper also presents some differences between regions in terms of the impact of heat waves: in the lowland region of Wielkopolska, the mortality rate is generally higher than in the upland region of Malopolska.