Severe hypothermia is a rare phenomenon, the incidence of which is increasing due in part to an ageing population at risk of falls. Its management is complex, given the hemodynamic impairment and consciousness disorders that are often concomitantly present. A systematic approach is key to improving outcome. Management focuses on rewarming, which can be associated with adverse effects depending on the patient'sunderlying condition and the degree and duration of hypothermia. This article reviews the management of severe hypothermia.