A comprehensive review of the scientific and clinical studies that have led to the resurgence of interest in hypothermia as a neuroprotective strategy in the treatment of stroke and traumatic brain injury. Topics of special importance include intraoperative and intensive care management of hypothermia-treated patients, a critical look at the potential for combining hypothermia with pharmacotherapy, and an update on the latest technological advances that have made hypothermic treatment possible in today's clinical setting.