Introduction: Workers in open pit mines are frequently exposed to extreme heat stress during hot seasons. Several indices including Modified Discomfort Index (MDI) are used to evaluate the heat stress. The aim of this study was to evaluate the MDI and to investigate its relationship with ISO 7243 standard (Wet Bulb Globe Temperature index, WBGT) and physiological parameters of workers in an open pit mine. Material and Method: This cross-sectional study was conducted among 120 healthy male miners in an open pit mine during summer season in 2014. Physiological parameters including body core and skin temperature, heart rate and blood pressure were measured according to ISO 9886 standard. All environmental and physiological parameters were simultaneously measured and recorded during a work shift. The MDI and WBGT indices were calculated using the related formula. Statistical analysis was performed using the SPSS 22 software. Result: According to the criteria of MDI, about 29 percent of workers had the average level, 68 percent of workers experienced the intense level and 2.5 percent suffered from the extreme level of exposure to the heat stress. No case of light level exposure to heat stress was obtained among workers. A significant correlation was found between MDI and ISO standard index (WBGT). Statistically significant correlation were also found between MDI and physiological parameters (P<0.001); in which the highest correlation coefficient was found for the heart rate variable (r=0.589). Conclusion: Based on MDI, a high percentage of open pit mine workers were at risk of heat stress hazards. MDI had a moderate correlation with physiological parameters of the workers and showed a remarkable correlation with the WBGT.