Climate change will most likely increase the frequency of weather extremes in the future. Events such as heat waves may occur more often and proceed for longer time. Heat can have a huge impact on people’s health and higher mortality rates during heat waves are seen all over the world. In Sweden the local municipality has the responsibility for both healthcare of elder and community functions like drinking water. This study aimed to investigate how local Swedish municipalities work proactive against heat waves and if that differs between various geographic parts of the country. A survey was sent out to all local municipalities and got a response rate of 43%, 129 answers of 290. The result showed that nearly 83% of the respondents worked proactive against heat waves in some sort. Actions that they reported was mainly about developing routines and buying air conditions. Focus was to locate these actions in facilities like eldercare and healthcare for vulnerable groups. The proactive work was evenly distributed over the country and no geographic variations could be detected. The most prominent way to prevent health issues during heat waves is to be prepared and work with action plans before the heat occurs. This study indicates that proactive work against heat waves is something that a majority of the local Swedish municipalities work with. That can be seen as positive indication of the preparedness for future heat waves.