The purpose of this review article is to evaluate ventilation, within protective clothing, for its benefit towards heat loss. Literature from ventilation studies in the sports apparel, outdoor clothing, military, chemical, and firefighter protection industries will be examined for future research opportunities. Challenges to ventilation such as garment placement, protection, wearability, and durability will be discussed in the context of turnout suits. Ventilation designs will be considered for further evaluation in structural firefighter turnout garments. This article serves as the first comprehensive review of ventilation literature for structural firefighter turnout ensembles. Researchers, technologists, and functional apparel designers may all benefit from such a review. The value of ventilation and its potential contribution to current firefighter turnout research will be discussed.