Heat stress affects the estrus time and conception rate of sows. Compared with other life stages of pigs, sows are more susceptible to heat stress because of their increased heat production. Various indicators can be found in the literature assessing the level of heat stress in pigs. However, none of them is specific to assess the sows’ thermal condition. Moreover, thermal indices are mainly developed by considering partial environment parameters, and there is no interaction between the index and the animal’s physiological response. Therefore, this study aims to develop a thermal index specified for sows, called equivalent temperature index for sows (ETIS), which includes parameters of air temperature, relative humidity and air velocity. Based on the heat transfer characteristics of sows, multiple regression analysis is used to combine air temperature, relative humidity and air velocity. Environmental data are used as independent variables, and physiological parameters are used as dependent variables. In 1029 sets of data, 70% of the data is used as the training set, and 30% of the data is used as the test set to create and develop a new thermal index. According to the correlation equation between ETIS and temperature-humidity index (THI), combined with the threshold of THI, ETIS was divided into thresholds. The results show that the ETIS heat stress threshold is classified as follows: suitable temperature ETIS < 33.1 °C, mild temperature 33.1 °C ≤ ETIS < 34.5 °C, moderate stress temperature 34.5 °C ≤ ETIS < 35.9 °C, and severe temperature ETIS ≥ 35.9 °C. The ETIS model can predict the sows’ physiological response in a good manner. The correlation coefficients R of skin temperature was 0.82. Compared to early developed thermal indices, ETIS has the best predictive effect on skin temperature. This index could be a useful tool for assessing the thermal environment to ensure thermal comfort for sows.