Abstract Problem Increasing extreme heat events of summer 2003, 2010 and 2015 induced a rising impact on heat health morbidity and mortality in Germany. A considerable proportion of urban population is affected by thermal discomfort due to the urban heat island burden during summer, particularly vulnerable people at risk. Concerted action to develop appropriate heat health adaptation measures is needed. Description As part of the National Adaptation Strategy to Climate Change an expert working group published ‘Recommendations for Action for the Preparation of Heat Action Plans’ for Germany in 2017. A first country-wide project had been conducted between 2019 and 2023 which investigated the status and impact of current or planned Heat Health Action Plans (HHAP), and adaptation measures appropriate to protect and prevent human health. As part of this project an online survey was conducted in May/June 2020 on the awareness and degree of use of the 2017 recommendations and the development and implementation of HHAP. Results This survey had been carried out to assess the current state of affairs as well as factors of success and barriers in the development and implementation of HHAP, with a particular focus on municipal environment and health administrations. In total 116 questionnaires had been responded, mainly by participants from the environment sector (53%), and 32% from the public health sector. More than half of the respondents indicated to be aware of the recommendations (very well-known at the federal state level: 90%, at county level known by 43%), which were identified as very helpful by 81%. Respondents from large cities (> 100 000 inhabitants) were main contributors to the study (41 of 81 large cities replied; 34 rural counties responded). Key messages • The 2017 recommendations had been identified and used to start with HHAP. • Decision makers should develop structures for regulations that anchor HHAP as a nationwide instrument to be established timely.