Randomised, controlled trials of therapeutic hypothermia have demonstrated improved outcomes after out-of-hospital cardiac arrest, where the initial cardiac rhythm was ventricular fibrillation. This therapy is now endorsed by the International Liaison Committee on Resuscitation. The role of therapeutic hypothermia in patients with anoxic neurological injury due to stroke, spinal cord injury or asphyxial cardiac arrest is uncertain. However, given the strong theoretical benefit and the minimal adverse side-effects, it is reasonable for clinicians to consider the use of therapeutic hypothermia in such cases.