Physicians caring for children in trauma settings must consider and treat hypothermia as a cause for morbidity and mortality. Knowledge of treatment of accidental hypothermia with and without an asphyxial event is paramount. Clinicians need to identify hypothermia immediately and be aware of the overall management utilizing aggressive rewarming and cardiopulmonary resuscitation to help improve the survival of these critically ill children. This section reviews the epidemiology, clinical effects, and management options for accidental hypothermia in children.