Therapeutic hypothermia has been shown to improve neurological outcome in comatose survivors of cardiac arrest. Uncontrolled hypothermia is, however, potentially deleterious because of its effects on various organ systems and physiologic functions. Clinicians are concerned that improper application of this treatment or overzealous cooling of their patients may result in serious complications and may increase the overall morbidity and mortality in that population. Induced hypothermia has, consequently, not achieved widespread use, despite an advisory statement from the International Liaison Committee on Resuscitation to cool comatose survivors of cardiac arrest. In this report, we critically review the literature on therapeutic hypothermia in individuals who have experienced cardiac arrest and the risks and complications associated with that treatment. Technical aspects and optimal timing for this intervention are also discussed, and appropriate monitoring of physiologic parameters is suggested.