Precise prediction of thermal comfort holds significant importance for the optimal design of buildings that aim to balance thermal comfort and energy efficiency. The Predicted Mean Vote (PMV) is broadly accepted and integrated into numerous national and international thermal comfort standards. However, across various contextual conditions, multiple studies have criticized the PMV for its less-than-ideal accuracy. Considering the pivotal role of skin temperature in thermal comfort and its oversimplified representation in the PMV, this chapter modifies the PMV by replacing the simplified skin temperature with values derived from the standard effective temperature model, with the goal of enhancing the model’s predictive performance. The simplified skin temperature only takes into account the influence of activity level, while disregarding the effects of clothing insulation and environmental factors. By incorporating a more intricate human thermoregulatory mechanism, the skin temperature obtained from the standard effective temperature model offers greater precision. The revised PMV is validated using the ASHRAE Global Thermal Comfort Database II, which shows a reduction in the original PMV’s overestimation of warm and cold discomforts across different contextual scenarios, such as climate types, building categories, and HVAC systems. Overall, the modified PMV enhances the accuracy and robustness of thermal sensation prediction by 62% and 56%, respectively. With its notably improved predictive capability, the revised PMV contributes to the updating of thermal comfort standards and the development of energy-efficient and thermally comfortable buildings.