The goal of this work is to discuss brain temperature as a physiological parameter, which reflects the balance between metabolism-related intra-brain heat production and heat loss by cerebral circulation to the rest of the body and then to the external environment. First, we present data on fluctuations in brain temperature occurring under physiological and behavioral conditions and discuss their mechanisms. Since most processes governing neural activity are temperature-dependent, we consider how naturally occurring temperature fluctuations could affect neural activity and neural functions. Then, we review brain temperature changes induced by psychomotor stimulants and show that the hyperthermic effects of these drugs are state-dependent and modulated by environmental conditions. Since high temperature could irreversibly damage neural cells and dramatically worsen various pathological processes, we consider the situations associated with pathological brain hyperthermia and evaluate its role in acute perturbations of brain functions, neurotoxicity, and neurodegeneration. We also discuss the complexities and limitations in consideration of brain temperature within the frameworks of physiological regulation and homeostasis. While different adaptive mechanisms could, within some limits, compensate for an altered heat balance of the brain, real life often creates situations when this balance could not be compensated, resulting in pathology and life-threatening health complications.