This study investigates the patterns of extreme heat during summers and their link to heat-related Emergency Medical Services (EMS) incidents in Austin-Travis County, Texas, focusing on 2020 and 2021. Analyzing 47,838 heat-related EMS cases, the research identifies significant correlations between high heat index (HI) frequency/intensity and increased EMS incidents, especially in East Austin. The findings highlight the area’s vulnerability to heat and the connection between heat vulnerability, urban growth patterns, and heat-related illnesses. The study underscores the need for targeted heat resilience strategies in urban planning and emergency response to address these health risks effectively.