The Intergovernmental Panel on Climate Change (IPCC) projects that the frequency of heat waves (HWs) is likely to increase over most land areas in the twenty-first century. Recurrent HWs are an emerging environmental and health concern and already distress in rapidly growing and fast urbanizing South Asia. A review of original research publications of the past five decades from peer-reviewed journals and conference proceedings, covering South Asia, revealed that the region is constantly experiencing the warmest temperatures. The review attempts to comprehend HWs in different contexts, geographic locations, and on previous studies. The paper presents a compre-hensive review of existing plans/policies/guidelines in South Asia at the national/regional/city level to counter extreme heat risk. The study is extended to identify the issues and gaps in the current policies and frameworks in the larger setting of urban planning measures for adaptation and mitigation efforts. A specific set of long-term actions and vulnerability assessment concen-trated on cities must be developed and integrated into a defined heat action plan coupled with improvements in urban and regional planning. Policies and actions must address the issues of the built environment in land use/planning and address the existing institutional and implementation gaps.