Therapeutic hypothermia is becoming an important intervention following acute neurologic injury despite inconclusive results concerning efficacy. This enthusiasm primarily stems from a lack of other effective interventions in this population. With the increase in the use of therapeutic hypothermia, several practical issues must be considered when initiating this intervention. Clinical pharmacists can play an important role in anticipating and addressing some complications such as shivering, slow drug metabolism, and infection. This review will discuss the available literature concerning the efficacy of therapeutic hypothermia in various neurologic injuries, as well as the most common adverse events associated with it.