As a quantum device, a quantum heat engine (QHE) is described by a Hermitian Hamiltonian. However, since it is an open system, reservoirs must be imposed phenomenologically without any description in the context of quantum mechanics. A non-Hermitian system is expected to describe an open system that exchanges energy and particles with external reservoirs. Correspondingly, such an exchange can be adiabatic in the context of quantum mechanics. We first propose a non-Hermitian QHE by a concrete simple two-level system, which is an spin in a complex external magnetic field. The non-Hermitian -symmetric Hamiltonian, as a self-contained one, describes both the working medium and reservoirs. A heat engine cycle is composed of completely quantum adiabatic processes. Surprisingly, the heat efficiency is obtained to be the same as that of the Hermitian quantum Otto cycle. A classical analog of this scheme is also presented. Our finding paves the way for revealing the role of a non-Hermitian Hamiltonian in physics.