The cardiovascular effects of whole body heat stress during exercise are well established. However the independent contribution of elevated skin temperature (T sk ) or core temperature (T c ) on these responses remains unclear. The purpose of this study was to determine how increases in T sk and T c alone and in combination, impact cardiovascular responses during moderate intensity exercise. To accomplish this goal, eight healthy, recreationally active males were immersed to the neck in a cold (14 -17°C) or hot (40 -42.5°C) water bath for 20 to 25 min to alter T c immediately prior to exercise with either cool T sk (i.e. fans) or warm T sk (i.e. heaters). Conditions during exercise were cool skin and cool core (CC), warm skin and cool core (WC), cool skin and warm core (CW), and warm skin and warm core (WW), and were conducted in a randomized crossover design. v When data was combined (n=16), warm core conditions (CW and WW) were associated with significantly higher average heart rate (HR) and lower stroke volume (SV) during exercise compared to cool core conditions (CC and WC); 168.1 ± 3.2 vs.152.2 ± 4.0 beats/min and 139.2 ± 7.3 vs. 147.7 ± 9.4 mL/beat, respectively. The approximate 9 mL/beat decline in SV and 16 beat/min increase in HR in warm core conditions tended to increase cardiac output (Q), 23.2 ± 0.6 vs. 22.2 ± 0.7 L/min, P=0.078. Similarly, warm T sk conditions (WC and WW) were associated with significantly higher average HR and lower SV during exercise compared to cool T sk conditions (CC and CW); 165.2 ± 3.3 vs. 155.1 ± 3.4 beats/min and 140.8 ± 7.8 vs. 146.0 ± 8.7 mL/beat, respectively. Additionally, there was also a trend for Q to be elevated with warm skin (23.0 ± 0.6 vs. 22.4 ± 0.6, P=0.075). Although combined data indicated that warm T sk conditions significantly lowered average SV by ~6 mL/beat, there was no reduction in SV during exercise by warm T sk , when T es was cool (i.e. <37.0°C), as evidenced by identical values for SV in CC and WC, 147.7 ± 9.8 vs. 147.7 ± 9.0 mL/beat, respectively. In contrast, SV was significantly lower in WW compared with CW, 133.9 ± 7.0 vs. 144.4 ± 7.8 mL/beat, respectively. Therefore, the major reduction in SV by warm T sk occurred during WW, when T es was elevated (i.e. >38.0°C).Analyzing data independently for precooling and preheating conditions revealed that warm T sk was associated with greater HR drift from 5 to 20 min of exercise, compared to cool T sk , when esophageal temperature (T es ) was both cool or warm (23.9 ± 2.2 vs. 17.5 ± 2.3 and 12.3 ± 1.3 vs. 4.6 ± 1.7 beats/min, respectively). These observations demonstrate that both T es and T sk can directly influence cardiovascular vi responses during exercise, as indicated by elevations in HR during exercise with warm T sk , with both warm and cool T es . However SV is not compromised by warm T sk if T es is below 37.5°C. Furthermore, when both T es and T sk are elevated simultaneously, cardiovascular strain (i.e. increased HR and reduced SV) is much greater than when either is elevated alone. This is d...