Background Indirect calorimetry is a noninvasive and reliable means of determining resting metabolic rate in humans. Barriers to obtaining an accurate measure of resting metabolic rate in hospitalized patients include the expense and the requirement of technical expertise for maintenance. Methods A literature search on hand-held calorimeters was conducted using PubMed and OVID. The search resulted in a total of 54 published articles; 23 of these specifically are about hand-held calorimeter devices. Results Results from a hand-held calorimeter were similar to those obtained from metabolic cart studies. The Douglas bag method compared to the MedGem indicated a significant agreement with a p=0.286. The hand-held device compared to metabolic carts in 9 studies with mixed results. The predictive equations (Harris-Benedict, Mifflin St. Joer and FAO/WHO equations) were found to over and underestimate RMR compared to the MedGem. The Harris-Benedict was found to overestimate the RMR by 3-11%, the Mifflin St Joer equation overestimated the RMR by 1% and the FAO/WHO equation overestimated RMR by 12%. Conclusion The present study examines the validity and reliability of hand-held calorimeters for measuring resting energy expenditure based on published literature. Hand-held calorimeters are more accurate than predictive equations based on gender, age and ethnicity for determining resting metabolic rate and are therefore a viable alternative for clinical evaluation of the hospitalized patient.