Abstract Background Extreme Heat Events (EHEs) are a growing threat to public health. The increase in the frequency of occurrence of once rarer EHEs and the rise in their average temperatures are dangerously drastic for public health outcomes. Despite this, existing public health surveillance (PHS) systems fail to leverage IoT and AI technologies to facilitate real-time, continuous monitoring of EHE indicators and its associated health risks. This study closes this gap by proposing a comprehensive PHS system that can, in real-time monitor and predict EHE indicators to provide timely alerts to public health authorities. Methods The EHE PHS system collects EHE detection metrics, including indoor temperature and humidity levels, from IoT sensors and thermostats to map them across Canada, primarily focusing on low-income communities. The system also integrates historical climate data (surface temperature, humidity, wind speed and direction, and air quality indicators) from Environment Canada. The system uses the data to train initial prediction models including CNN, LSTM and GNN. The validated model will be integrated into the system, enabling real-time EHE prediction. The output will be displayed in user-friendly visualizations on the EHE PHS system’s dashboard capabilities. Results The system allows for the analysis of real-time data through dashboards and provides alerts when certain indicators (e.g. excessive or prolonged heat) detrimental to public health outcomes are detected. The alerts enable valuable lead time for public health authorities to implement proactive measures, such as issuing heat advisories and deploying resources to vulnerable areas. Conclusions The EHE PHS system will serve as a blueprint for global public health researchers, utilizing IoT and AI technologies for proactive crisis prevention. This knowledge will inform the development of heat-resilient policies and set a precedent for global public health crisis prevention. Key messages • The proposed EHE PHS system uses AI and IoT technologies, to enhance EHE prediction, risk identification, and real-time monitoring for effective public health interventions. • By integrating advanced predictive models and environmental data, the system facilitates early detection of EHE risk, which can significantly mitigate the health impact on vulnerable populations.