An impact-based heat health warning system was developed by the National Institute of Meteorological Sciences based on 165 counties in South Korea. This system was developed using the daily maximum perceived temperature (PTmax), which is a human physiology-based thermal comfort index, and the Local ENSemble prediction system for the probability forecasts. Also, A risk matrix proposed by the World Meteorological Organization was employed for the impact-based forecasts of this system. The threshold value of the risk matrix was separately set depending on regions. In this system, the risk level was issued as four levels (GREEN, YELLOW, ORANGE, RED) for first, second, and third forecast lead-day (LD1, LD2, and LD3). The daily risk level issued by the system was evaluated using emergency heat-related patients obtained at six cities, including Seoul, Incheon, Daejeon, Gwangju, Daegu, and Busan, for LD1 to LD3. The high-risks level occurred more consistently in the shorter lead time (LD3  LD1) and the performance (rs) was increased from 0.42 (LD3) to 0.45 (LD1) in all cities. Especially, it showed good performance (rs = 0.51) in July and August, when heat stress is highest in South Korea. From an impact-based forecasting perspective, PTmax is one of the most suitable temperature indicators for issuing the health risk warnings by heat in South Korea.