South Asia is increasingly recognized as a global hotspot of extreme heat, with rising temperatures posing significant risks to human health, ecosystems, and economic stability. This study analyzes spatiotemporal trends in heat extremes across Pakistan, India, and Bangladesh during 2001–2024 using historical climate datasets. Heatwaves were identified using a percentile-based approach, defining events as periods of at least three consecutive days when daily maximum temperature exceeded the 90th (or 95th, depending on your method) percentile of the reference baseline period. Key indicators, including heatwave frequency, duration, and intensity, were calculated alongside land-use and urbanization patterns derived from satellite-based datasets. Trend analysis was conducted to assess temporal changes, while future projections were interpreted using established CMIP6 climate scenario frameworks. The results reveal a significant increase in the frequency and intensity of heatwaves across the region, particularly in urban and semi-arid areas. Anthropogenic factors such as rapid urbanization, deforestation, and land-use change are associated with localized intensification of heat extremes. Increasing humidity levels are further amplifying thermal stress, bringing conditions closer to critical human heat tolerance thresholds. Future projections indicate a substantial escalation in extreme heat events under high-emission scenarios. These findings highlight urgent climate risks for South Asia, including threats to public health, agriculture, water resources, and energy systems. Strengthening regional cooperation, implementing heat-resilient urban planning, and enhancing early warning systems are essential to improving climate resilience.