Increasingly severe extreme weather events (EWEs) threaten population health in Asia-Pacific. Resilient health systems can minimize health risks by improving EWE preparedness, response, and recovery. However, how health systems demonstrate resilience is less understood in the emerging resilience literature. The objective of this scoping review was to describe how peer-reviewed and grey literature has operationalized health system resilience to EWEs in Asia-Pacific. Included sources were available in English, published from 2000 to 2019, and focused on health system activity in Asia-Pacific for EWE risk management. The World Health Organization's climate-resilient health system framework and building block model guided analysis of 49 sources. Health system activity was categorized by system building blocks. Assets and/or gaps to resilience were identified based on whether building blocks facilitated or impeded EWE risk management. Sources mostly focused on the Philippines (29%), India (16%) and Thailand (14%), with lower income economies and Pacific Island countries underrepresented. Floods (47%), typhoons (27%), and cyclones (16%) were frequently discussed while no sources mentioned droughts. Financing was the least mentioned building block (27%) and often described as a gap to resilience (24%). Overall, this review highlights opportunities for future research to develop EWE resilient health systems in Asia-Pacific and beyond.