Under climate change, many parts of the world are warming with increasing frequencies and intensities of heatwaves, bringing heat-health risks to places including those that have a historically temperate or cool climate. These places may have extensive experience in managing cold-health risks, while experience is lacking in dealing with heat-health risks due to their lack of historical exposure to high temperatures. This paper explores this overlooked area of the challenges and opportunities of heat-health governance in cool places using Scotland as a case study. Various important themes of heat-health governance in cool places were identified by the study, including socio-cultural barriers to intervention, vulnerable population overlaps, temporal and geographical scales, and governance arrangements. The study found challenges in managing heat-health risks including a perceived lack of heat-health risks and policy priority as well as unsuitable building stock. Meanwhile, it also identified opportunities for governing cold and heat risks holistically within existing institutional systems and creating co-benefits of improving communication and information dissemination, reducing inequality and improving indoor thermal comfort of both cold and heat as well as providing good quality greenspace. Our findings contribute to the development or improvement of national/regional strategies to manage heat-health risks not only in Scotland but also in other places with a historically cool or temperate climate.