The aim of this systematic review was to review the recent literature regarding the effect of heat waves on mortality in elderly adults. A systematic search of the literature, was conducted by two reviewers during March 2018, using three electronic databases (PubMed, Web of Science, and Scopus). The PRISMA guidelines were used for the quality assessment of the published studies. The literature search identified a total of 345 articles, while only 24 studies met the inclusion criteria and were included in this analysis. Overall, the results from these studies show that, although recent advances in technology allow scientists to predict heat waves, thereby enabling health agencies to alert the public with heat advisories, the number of heat wave-induced deaths remains high. The underlying reasons for these increases in heat-wave-induced mortality remains unclear, highlighting the need for developing evidence-based thresholds for the activation and implementation of actions plans to protect the health of heat-vulnerable elderly populations.