This is the first assessment of the implementation of extreme heat policies in multiple cities in India. Using an ensemble of climate models from CMIP6, it focuses on just over 11 percent of India’s urban population (Census of India, 2011) in some of its most at-risk cities to future heat as the climate warms. Through interviews with 88 government officials in disaster management, health,city planning, and labour departments, as well as city and district administrators, we find that while all cities reported implementing short-term response measures to prevent the loss of lives during heat waves, there was a significant gap in their long-term preparedness for future heat. Inconsistent and weakly targeted long-term heat actions suggest that India will likely see heat waves with higher mortality levels more frequently in the coming years as short-term life-saving responses and communities’ adaptive capacities are overwhelmed by rising temperatures. We show that this pattern of policy implementation arises because of a mix of weakly institutionalised heat action plans, limited public support for longterm measures, and an interconnected set of institutional constraints, based on which we identify policy recommendations to make ongoing heat actions more responsive to future heat.