Research on summertime extreme heat patterns and their link to heat-related Emergency Medical Services (EMS) incidents remains limited, despite rising concerns about heat waves and their health impacts. This study explores spatiotemporal patterns of the heat index (HI) and its relationship to heat-related EMS incidents in Austin-Travis County, Texas, during the summers of 2020 and 2021. Analyzing 47,838 heat-related EMS cases at the tract level (N = 290), the study employs various analytical methods to identify disparities in heat-related health outcomes. Key findings reveal a significant correlation between high HI and increased EMS incidents, especially in East Austin, highlighting its vulnerability. The study indicates that heat vulnerability and urban growth patterns are closely linked to heat-related illnesses, with regional variations. These results underscore the need for targeted heat resilience strategies in urban planning and emergency response. Combining socio-economic and environmental data, this research offers insights into heat-related health risks, informing public health policies and urban planning for more equitable interventions.