BACKGROUND: Heat-related illness (HRI) is an occupational health risk for many outdoor, and some indoor, workers. METHODS: Emergency department (ED) and inpatient hospitalization (IH) data for 2007-2011 from nine southeast states were analyzed to identify occupational HRI numbers and rates, demographic characteristics, and co-morbid conditions. RESULTS: There were 8,315 occupational HRI ED visits (6.5/100,000 workers) and 1,051 IHs (0.61/100,000) in the southeast over the study period. Out-of-state residents comprised 8% of ED visits and 12% of IHs. Rates for both, ED visits and IHs were significantly elevated in males and blacks. Younger workers had elevated rates for ED visits, while older workers had higher IH rates. CONCLUSIONS: This is the first study to evaluate occupational HRI ED visits and IHs in the southeast region and indicates the need for enhanced heat-stress prevention policies in the southeast. Findings from this study can be used to direct state health department tracking and evaluation of occupational HRI.