Strenuous exercise and activity in hot and humid environments often results in hyperthermia, which can impair physical and cognitive functioning as well as increase the risk for dehydration. Heat stress leads to a thermal strain on the body that if left untreated can quickly escalate into various levels of heat illness, including heat cramps, heat exhaustion, heat stroke and possibly death (American Heart Association [AHA], 2011; Brade et al., 2010; Lopez et al., 2008). Heat illness is particularly concerning for certain occupations, such as firefighting. The combination of harsh environmental conditions, highly insulated personal protective equipment (PPE) and the strenuous work involved in firefighting makes firefighters especially susceptible to the dangers of heat stress (Smith et al., 2008). The increased risks associated with heat stress and strain in firefighting makes on-scene active cooling critical to maintaining the health and safety of firefighters (Barr et al., 2009; Bull, 2008; Chou, 2009; Giesbrecht et al., 2007). The current study looks at the effectiveness of forearm and hand immersion and cold towels on reducing the negative physiological and cognitive effects of heat stress on firefighters.