Extreme heat occurrence worldwide has increased in the past decades. Greenhouse gas emissions, if not abated aggressively, will lead to large increases in frequency and intensity of heat extremes. At the same time, many cities are facing severe air pollution problems featuring high‐PM episodes that last from days to weeks. Based on a high‐resolution decadal‐long model simulation using a state‐of‐the‐science regional chemistry‐climate model that is bias corrected against reanalysis, here we show that when daily average wet‐bulb temperature of 25 °C is taken as the threshold for severe health impacts, heat extremes frequency averaged over South Asia increases from 45 ± 5 days/year in 1997–2004 to 78 ± 3 days/year in 2046–2054 under RCP8.5 scenario. With daily averaged PM2.5 surface concentration of 60 μg/m3 defined as the threshold for such “unhealthy” extremes, high‐PM extremes would occur 132 ± 8 days/year in the Decade 2050 under RCP8.5. Even more concerning, due to the potential health impacts of two stressors acting in tandem, is the joint occurrence of the heatwave and high‐PM hazard (HHH), which would have substantial increases of 175% in frequency and 79% in duration. This is in contrast to the 73–76% increase for heatwave or high PM when assessed individually. The fraction of land exposed to prolonged HHH increases by more than tenfold in 2050. The alarming increases in just a few decades pose great challenges to adaptation and call for more aggressive mitigation. For example, under a lower emission pathway, the frequency of HHH will only increase by 58% with a lower frequency of high‐PM extremes.