The use of rapid infusion of large-volume cold saline (CS) as an adjunctive therapy for treating refractory fever in nine patients is reported. A decline in temperature (39.2 +/- 0.3 vs 37.1 +/- 1.2 degrees C, p = 0.006) at 2 hours and fever burden (97.3 +/- 343.8 vs 734.3 +/- 422.3 degrees C*min, p = 0.02) at 12 hours was noted after CS bolus. Rapid infusion of large-volume CS may be used as an adjunct for inducing normothermia in refractory febrile patients.